Aim
Recent studies have shown that sarcopenia is associated with negative postoperative outcomes. However, none of these studies analysed muscle strength or physical performance, which are also ...important components of sarcopenia. The present study aimed to investigate whether sarcopenia itself, as defined by low muscle mass, strength and physical performance, would predict complications after surgery for colorectal cancer.
Method
We conducted a prospective study of patients who underwent surgery for colorectal cancer at our department between August 2014 and February 2015. Sarcopenia was diagnosed by a combination of third lumbar vertebra muscle index (L3 MI), handgrip strength and 6‐m usual gait speed. Univariate and multivariate analyses evaluating the risk factors for postoperative complications were performed. Only complications classified as Grade II or above according to the Clavien–Dindo classification were analysed in this study.
Results
A total of 142 patients were included in the study, and 17 patients were diagnosed as having sarcopenia. Postoperative complications of Grade II or above occurred in 40 patients, including 10 with sarcopenia and 30 without sarcopenia. Multivariate analysis showed that sarcopenia and previous abdominal surgery were independent risk factors for postoperative complications. Patients with sarcopenia also had an obvious tendency to a higher incidence of infectious complications. By comparing two logistic regression models, sarcopenia showed a better predictive power for postoperative complications than did low muscle mass.
Conclusion
Sarcopenia and previous abdominal surgery are independent risk factors for complications after surgery for colorectal cancer. Including a functional aspect to the definition of sarcopenia may result in a better prediction of postoperative complications.
Summary Background Until now, polymyxin resistance has involved chromosomal mutations but has never been reported via horizontal gene transfer. During a routine surveillance project on antimicrobial ...resistance in commensal Escherichia coli from food animals in China, a major increase of colistin resistance was observed. When an E coli strain, SHP45, possessing colistin resistance that could be transferred to another strain, was isolated from a pig, we conducted further analysis of possible plasmid-mediated polymyxin resistance. Herein, we report the emergence of the first plasmid-mediated polymyxin resistance mechanism, MCR-1, in Enterobacteriaceae. Methods The mcr-1 gene in E coli strain SHP45 was identified by whole plasmid sequencing and subcloning. MCR-1 mechanistic studies were done with sequence comparisons, homology modelling, and electrospray ionisation mass spectrometry. The prevalence of mcr-1 was investigated in E coli and Klebsiella pneumoniae strains collected from five provinces between April, 2011, and November, 2014. The ability of MCR-1 to confer polymyxin resistance in vivo was examined in a murine thigh model. Findings Polymyxin resistance was shown to be singularly due to the plasmid-mediated mcr-1 gene. The plasmid carrying mcr-1 was mobilised to an E coli recipient at a frequency of 10−1 to 10−3 cells per recipient cell by conjugation, and maintained in K pneumoniae and Pseudomonas aeruginosa . In an in-vivo model, production of MCR-1 negated the efficacy of colistin. MCR-1 is a member of the phosphoethanolamine transferase enzyme family, with expression in E coli resulting in the addition of phosphoethanolamine to lipid A. We observed mcr-1 carriage in E coli isolates collected from 78 (15%) of 523 samples of raw meat and 166 (21%) of 804 animals during 2011–14, and 16 (1%) of 1322 samples from inpatients with infection. Interpretation The emergence of MCR-1 heralds the breach of the last group of antibiotics, polymyxins, by plasmid-mediated resistance. Although currently confined to China, MCR-1 is likely to emulate other global resistance mechanisms such as NDM-1. Our findings emphasise the urgent need for coordinated global action in the fight against pan-drug-resistant Gram-negative bacteria. Funding Ministry of Science and Technology of China, National Natural Science Foundation of China.
Anthropogenic atmospheric emissions of typical toxic heavy metals have caused worldwide concern due to their adverse effects on human health and the ecosystem. By determining the best available ...representation of time-varying emission factors with S-shape curves, we establish the multiyear comprehensive atmospheric emission inventories of 12 typical toxic heavy metals (Hg, As, Se, Pb, Cd, Cr, Ni, Sb, Mn, Co, Cu, and Zn) from primary anthropogenic activities in China for the period of 1949-2012 for the first time. Further, we allocate the annual emissions of these heavy metals in 2010 at a high spatial resolution of 0.5 degree 0.5 degree grid with ArcGIS methodology and surrogate indexes, such as regional population and gross domestic product (GDP). Our results show that the historical emissions of Hg, As, Se, Cd, Cr, Ni, Sb, Mn, Co, Cu, and Zn, during the period of 1949-2012, increased by about 22-128 times at an annual average growth rate of 5.1-8.0 %, reaching about 526.9-22 319.6 t in 2012. Nonferrous metal smelting, coal combustion of industrial boilers, brake and tyre wear, and ferrous metal smelting represent the dominant sources of heavy metal emissions. In terms of spatial variation, the majority of emissions are concentrated in relatively developed regions, especially for the northern, eastern, and southern coastal regions. In addition, because of the flourishing nonferrous metal smelting industry, several southwestern and central-southern provinces play a prominent role in some specific toxic heavy metals emissions, like Hg in Guizhou and As in Yunnan. Finally, integrated countermeasures are proposed to minimize the final toxic heavy metals discharge on account of the current and future demand of energy-saving and pollution reduction in China.
Large-scale, highly integrated and low-power-consuming hardware is becoming progressively more important for realizing optical neural networks (ONNs) capable of advanced optical computing. ...Traditional experimental implementations need N
units such as Mach-Zehnder interferometers (MZIs) for an input dimension N to realize typical computing operations (convolutions and matrix multiplication), resulting in limited scalability and consuming excessive power. Here, we propose the integrated diffractive optical network for implementing parallel Fourier transforms, convolution operations and application-specific optical computing using two ultracompact diffractive cells (Fourier transform operation) and only N MZIs. The footprint and energy consumption scales linearly with the input data dimension, instead of the quadratic scaling in the traditional ONN framework. A ~10-fold reduction in both footprint and energy consumption, as well as equal high accuracy with previous MZI-based ONNs was experimentally achieved for computations performed on the MNIST and Fashion-MNIST datasets. The integrated diffractive optical network (IDNN) chip demonstrates a promising avenue towards scalable and low-power-consumption optical computational chips for optical-artificial-intelligence.
This review recognizes a unique calcium phosphate (CaP) phase known as monetite or dicalcium phosphate anhydrous (DCPA, CaHPO4), and presents an overview of its properties, processing, and ...applications in orthopedics. The motivation for the present effort is to highlight the state-of-the-art research and development of monetite and propel the research community to explore more of its potentials in orthopedics. After a brief introduction of monetite, we provide a summary of its various synthesis routes like dehydration, solvent-based, energy-assisted processes and also discuss the formation of different crystal structures with respect to the synthesis conditions. Subsequently, we discuss the material's noteworthy physico-chemical properties including the crystal structure, vibrational spectra, solubility, thermal decomposition, and conversion to other phases. Of note, we focus on the biological (in vitro and in vivo) properties of monetite, given its ever-increasing popularity as a biomaterial for medical implants. Appropriately, we discuss various orthopedic applications of monetite as bone cement, implant coatings, granules for defect fillers, and scaffolds. Many in vitro and in vivo studies confirmed the favorable osteointegration and osteoconduction properties of monetite products, along with a better balance between implant resorption and new bone formation as compared to other CaP phases. The review ends with translational aspects of monetite and presents thoughts about its possible future research directions. Further research may explore but not limited to improvements in mechanical strength of monetite-based scaffolds, using monetite particles as a therapeutic agent delivery, and tissue engineering strategies where monetite serves as the biomaterial.
This is the first review that focusses on the favorable potential of monetite for hard tissue repair and regeneration. The article accurately covers the “Synthesis-Structure-Property-Applications” correlations elaborating on monetite's diverse material properties. Special focus is put on the in vitro and in vivo properties of the material highlighting monetite as an orthopedic material-of-choice. The synthesis techniques are discussed which provide important information about the different fabrication routes for monetite. Most importantly, the review provides comprehensive knowledge about the diverse biomedical applications of monetite as granules, defect--specific scaffolds, bone cements and implant coatings. This review will help to highlight monetite's potential as an effective regenerative medicine and catalyze the continuing translation of this bioceramic from the laboratory to clinics.
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The approach of combining computational fluid dynamics (CFD) for continuum fluid and the discrete element method (DEM) for discrete particles has been increasingly used to study the fundamentals of ...coupled particle–fluid flows. Different CFD–DEM models have been used. However, the origin and the applicability of these models are not clearly understood. In this paper, the origin of different model formulations is discussed first. It shows that, in connection with the continuum approach, three sets of formulations exist in the CFD–DEM approach: an original format set I, and subsequent derivations of set II and set III, respectively, corresponding to the so-called model A and model B in the literature. A comparison and the applicability of the three models are assessed theoretically and then verified from the study of three representative particle–fluid flow systems: fluidization, pneumatic conveying and hydrocyclones. It is demonstrated that sets I and II are essentially the same, with small differences resulting from different mathematical or numerical treatments of a few terms in the original equation. Set III is however a simplified version of set I. The testing cases show that all the three models are applicable to gas fluidization and, to a large extent, pneumatic conveying. However, the application of set III is conditional, as demonstrated in the case of hydrocyclones. Strictly speaking, set III is only valid when fluid flow is steady and uniform. Set II and, in particular, set I, which is somehow forgotten in the literature, are recommended for the future CFD–DEM modelling of complex particle–fluid flow.
TY Pup is a well-known bright eclipsing binary with an orbital period of 0.8192 days. New light curves in B, V, (RI)C bands were obtained with the 0.61 m reflector robotic telescope (PROMPT-8) at ...CTIO in Chile during 2015 and 2017. By analyzing those photometric data with the W-D method, it is found that TY Pup is a low-mass-ratio (q ∼ 0.184) and deep-contact binary with a high fill-out factor (84.3%). An investigation of all available times of minimum light including three new ones obtained with the 60 cm and the 1.0 m telescopes at Yunnan Observatories in China indicates that the period change of TY Pup is complex. An upward parabolic variation in the O − C diagram is detected to be superimposed on a cyclic oscillation. The upward parabolic change reveals a long-term continuous increase in the orbital period at a rate of dP/dt = 5.57( 0.08) × 10−8 days yr−1. The period increase can be explained by mass transfer from the less massive component (M2 ∼ 0.3 M ) to the more massive one (M1 ∼ 1.65 M ). The binary will be merging when it meets the criterion that the orbital angular momentum is less than three times the total spin angular momentum, i.e., Jorb < 3Jrot. This suggests that the system will finally merge into a rapid-rotating single star and may produce a luminous red nova. The cyclic oscillation in the O − C diagram can be interpreted by the light-travel time effect via the presence of a third body.
The accumulation of myeloid-derived suppressor cells (MDSCs) has been observed in solid tumors and is correlated with tumor progression; however, the underlying mechanism is still poorly understood. ...In this study, we identified a mechanism by which tumor cells induce MDSC accumulation and expansion in the bladder cancer (BC) microenvironment via CXCL2/MIF-CXCR2 signaling. Elevated expression of CXCL2 and MIF and an increased number of CD33
MDSCs were detected in BC tissues, and these increases were significantly associated with advanced disease stage and poor patient prognosis (P<0.01). A positive association was observed between CXCL2 or MIF expression and the number of tumor-infiltrating CD33
MDSCs (P<0.01). Subsequently, we demonstrated that CD45
CD33
CD11b
HLA-DR
MDSCs from fresh BC tissues displayed high levels of suppressive molecules, including Arg1, iNOS, ROS, PDL-1 and P-STAT3, and stronger suppression of T-cell proliferation. Interestingly, these CD45
CD33
CD11b
HLA-DR
MDSCs exhibited increased CXCR2 expression compared with that in peripheral blood from BC patients or healthy controls (P<0.05). Chemotaxis assay revealed that bladder cancer cell line J82 induced MDSC migration via CXCL2/MIF-CXCR2 signaling in vitro. Mechanistic studies demonstrated that J82-induced MDSC trafficking and CXCR2 expression were associated with increased phosphorylation of p38, ERK and p65. Conversely, inhibition of the phosphorylation of p38, ERK or p65 decreased J82-induced MDSC trafficking and CXCR2 expression. CXCL2/MIF-stimulated activation of the mitogen-activated protein kinase and nuclear factor kappa B pathways in MDSCs was MyD88 dependent. Overall, our results identify the CXCL2/MIF-CXCR2 axis as an important mediator in MDSC recruitment and as predictors and potential therapeutic targets in BC patients.
Abstract Background Pathogenesis and diagnostic biomarkers for diseases can be discovered by metabolomic profiling of human fluids. If the various types of coronary artery disease (CAD) can be ...accurately characterized by metabolomics, effective treatment may be targeted without using unnecessary therapies and resources. Objectives The authors studied disturbed metabolic pathways to assess the diagnostic value of metabolomics-based biomarkers in different types of CAD. Methods A cohort of 2,324 patients from 4 independent centers was studied. Patients underwent coronary angiography for suspected CAD. Groups were divided as follows: normal coronary artery (NCA), nonobstructive coronary atherosclerosis (NOCA), stable angina (SA), unstable angina (UA), and acute myocardial infarction (AMI). Plasma metabolomic profiles were determined by liquid chromatography–quadrupole time-of-flight mass spectrometry and were analyzed by multivariate statistics. Results We made 12 cross-comparisons to and within CAD to characterize metabolic disturbances. We focused on comparisons of NOCA versus NCA, SA versus NOCA, UA versus SA, and AMI versus UA. Other comparisons were made, including SA versus NCA, UA versus NCA, AMI versus NCA, UA versus NOCA, AMI versus NOCA, AMI versus SA, significant CAD (SA/UA/AMI) versus nonsignificant CAD (NCA/NOCA), and acute coronary syndrome (UA/AMI) versus SA. A total of 89 differential metabolites were identified. The altered metabolic pathways included reduced phospholipid catabolism, increased amino acid metabolism, increased short-chain acylcarnitines, decrease in tricarboxylic acid cycle, and less biosynthesis of primary bile acid. For differential diagnosis, 12 panels of specific metabolomics-based biomarkers provided areas under the curve of 0.938 to 0.996 in the discovery phase (n = 1,086), predictive values of 89.2% to 96.0% in the test phase (n = 933), and 85.3% to 96.4% in the 3-center external sets (n = 305). Conclusions Plasma metabolomics are powerful for characterizing metabolic disturbances. Differences in small-molecule metabolites may reflect underlying CAD and serve as biomarkers for CAD progression.
To identify the bacterial and archaeal composition in a mesophilic biogas digester treating pig manure and to compare the consistency of two 16S rDNA-based methods to investigate the microbial ...structure. Sixty-nine bacterial operational taxonomic units (OTU) and 25 archaeal OTU were identified by sequencing two 16S rDNA clone libraries. Most bacterial OTU were identified as phyla of Firmicutes (47·2% of total clones), Bacteroides (35·4%) and Spirochaetes (13·2%). Methanoculleus bourgensis (29·0%), Methanosarcina barkeri (27·4%) and Methanospirillum hungatei (10·8%) were the dominant methanogens. Only 9% of bacterial and 20% of archaeal OTU matched cultured isolates at a similarity index of greater-than-or-equal97%. About 78% of the dominant bacterial (with abundance >3%) and 83% of archaeal OTU were recovered from the denaturing gradient gel electrophoresis (DGGE) bands of V3 regions in 16S rDNAs. In the digester, most bacterial and archaeal species were uncultured; bacteria belonging to Firmicutes, Bacteroides and Spirochaetes seem to take charge of cellulolysis, proteolysis, acidogenesis, sulfur-reducing and homoacetogenesis; the most methanogens were typical hydrogenotrophic or hydrogenotrophic/aceticlastic; DGGE profiles reflected the dominant microbiota. This study gave a first insight of the overall microbial structure in a rural biogas digester and also indicated DGGE was useful in displaying its dominant microbiota.
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