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BackgroundAcute kidney injury (AKI) is a common complication after surgery and is associated with detrimental outcomes. This systematic review and meta-analysis evaluated perioperative dexmedetomidine on AKI and renal function after non-cardiac surgery.MethodsPubMed, Embase, and Cochrane Library databases were searched until August 2023 for randomised trials comparing dexmedetomidine with normal saline on AKI and renal function in adults undergoing non-cardiac surgery. The primary outcome was the incidence of AKI (according to Kidney Disease Improving Global Outcomes or Acute Kidney Injury Network criteria). Meta-analysis was performed using a random-effect model. We conducted sensitivity analysis, trial sequential analysis (TSA), and Grading of Recommendations Assessment, Development and Evaluation level of evidence.ResultsTwenty-three trials involving 2440 patients were included. Dexmedetomidine administration, as compared to normal saline, significantly reduced the incidence of AKI (7.4% vs. 13.2%; risk ratio = 0.57, 95% CI = 0.40 to 0.83, P =  0.003, I2 = 0%; a high level of evidence); TSA and sensitivity analyses suggested the robustness of this outcome. For the renal function and inflammation parameters, dexmedetomidine decreased serum creatinine, blood urea nitrogen, cystatin C, tumour necrosis factor-α, and interleukin-6, and increased urine output and estimated glomerular filtration rate. Additionally, dexmedetomidine reduced postoperative nausea and vomiting and length of hospital stay. Dexmedetomidine was associated with an increased rate of bradycardia, but not hypotension.ConclusionDexmedetomidine administration reduced the incidence of AKI and improved renal function after non-cardiac surgery. Based on a high level of evidence, dexmedetomidine is recommended as a component of perioperative renoprotection.RegistrationInternational Prospective Register of Systematic Reviews; Registration number: CRD42022299252.

BackgroundPostoperative delirium (POD) is common among older surgical patients and may be affected by dexmedetomidine and depth of anesthesia. We designed this pilot study to assess the feasibility of comparing dexmedetomidine with normal saline during light versus deep anesthesia on POD in older patients undergoing major noncardiac surgery.MethodsIn this pilot randomized factorial study, 80 patients aged 60 years or older undergoing major noncardiac surgery were randomized (1:1:1:1) to receive dexmedetomidine infusion 0.5 μg/kg/h or normal saline placebo during light (bispectral index [BIS] target 55) or deep (BIS target 40) anesthesia. Feasibility end points included consent rate and dropout rate, timely enrollment, blinded study drug administration throughout surgery, no inadvertent unmasking, achieving BIS target throughout >70% of surgery duration, and the process of twice-daily POD screening. In addition, we estimated the POD incidences in the 2 control groups (placebo and deep anesthesia) and treatment effects of dexmedetomidine and light anesthesia.ResultsBetween November 1, 2021, and June 30, 2022, 78 patients completed the trial (mean [standard deviation, SD] age, 69.6 [4.6] years; 48 male patients [62%]; dexmedetomidine-deep, n = 19; dexmedetomidine-light, n = 20; placebo-deep, n = 19; placebo-light, n = 20). This study had a high consent rate (86%) and a low dropout rate (2.5%). Average recruitment was 5 patients at each center per month. Dexmedetomidine and normal saline were administered in a blinded fashion in all patients. Unmasking did not occur in either group. Approximately 99% of patients received the scheduled study drug infusion throughout the surgery. Approximately 81% of patients achieved the BIS targets throughout >70% of the surgery duration. The scheduled twice-daily POD screening was completed without exception. Overall, 10 of the 78 patients (13%; 95% confidence interval [CI], 7%-22%) developed POD. For the 2 reference groups, POD was observed in 7 of the 39 patients (17.9%; 95% CI, 9%-32.7%) in the placebo group and 7 of the 38 patients (18.4%; 95% CI, 9.2%-33.4%) in the deep anesthesia group. Regarding the treatment effects on POD, the estimated between-group difference was -10% (95% CI, -28% to 7%) for dexmedetomidine versus placebo, and -11% (95% CI, -28% to 6%) for light versus deep anesthesia.ConclusionsThe findings of this pilot study demonstrate the feasibility of assessing dexmedetomidine versus placebo during light versus deep anesthesia on POD among older patients undergoing major noncardiac surgery, and justify a multicenter randomized factorial trial.

Objective To investigate the application value of combining the Demirjian’s method with machine learning algorithms for dental age estimation in northern Chinese Han children and adolescents. Methods Oral panoramic images of 10 256 Han individuals aged 5 to 24 years in northern China were collected. The development of eight permanent teeth in the left mandibular was classified into different stages using the Demirjian’s method. Various machine learning algorithms, including support vector regression （SVR）, gradient boosting regression （GBR）, linear regression （LR）, random forest regression （RFR）, and decision tree regression （DTR） were employed. Age estimation models were constructed based on total, female, and male samples respectively using these algorithms. The fitting performance of different machine learning algorithms in these three groups was evaluated. Results SVR demonstrated superior estimation efficiency among all machine learning models in both total and female samples, while GBR showed the best performance in male samples. The mean absolute error （MAE） of the optimal age estimation model was 1.246 3, 1.281 8 and 1.153 8 years in the total, female and male samples, respectively. The optimal age estimation model exhibited varying levels of accuracy across different age ranges, which provided relatively accurate age estimations in individuals under 18 years old. Conclusion The machine learning model developed in this study exhibits good age estimation efficiency in northern Chinese Han children and adolescents. However, its performance is not ideal when applied to adult population. To improve the accuracy in age estimation, the other variables can be considered.

We present a novel adaptive host-chip modular architecture for video acquisition to optimize an overall objective task constrained under a given bit rate. The chip is a high resolution imaging sensor such as gigapixel focal plane array (FPA) with low computational power deployed on the field remotely, while the host is a server with high computational power. The communication channel data bandwidth between the chip and host is constrained to accommodate transfer of all captured data from the chip. The host performs objective task specific computations and also intelligently guides the chip to optimize (compress) the data sent to host. This proposed system is modular and highly versatile in terms of flexibility in re-orienting the objective task. In this work, object tracking is the objective task. While our architecture supports any form of compression/distortion, in this paper we use quadtree (QT)-segmented video frames. We use Viterbi (Dynamic Programming) algorithm to minimize the area normalized weighted rate-distortion allocation of resources. The host receives only these degraded frames for analysis. An object detector is used to detect objects, and a Kalman Filter based tracker is used to track those objects. Evaluation of system performance is done in terms of Multiple Object Tracking Accuracy (MOTA) metric. In this proposed novel architecture, performance gains in MOTA is obtained by twice training the object detector with different system generated distortions as a novel 2-step process. Additionally, object detector is assisted by tracker to upscore the region proposals in the detector to further improve the performance. [ABSTRACT FROM AUTHOR]

This study presents new detrital zircon laser ablation inductively coupled plasma mass spectrometry (LA‐ICP‐MS) U–Pb ages and in situ Hf–O isotopic data in order to constrain the depositional age and provenance of the Benxi Formation in the Sanmenxia area of the southern North China Craton (NCC). Detrital zircons in quartz sandstone drillcore from the Benxi Formation are euhedral–subhedral, oscillatory zoned, and have high Th/U ratios (0.03–1.60, generally greater than 0.3) that are indicative of a magmatic origin. Detrital zircons from samples 13H16A and 13H16B yield seven (2544, 1788, 1123, 955, 737, 441, and 344 Ma) and six main age populations (2440, 1583, 951, 759, 434, and 348 Ma), respectively. The εHf(t) values of the Neoarchean–Paleoproterozoic zircons range from −11.3 to +13.9, and these zircons have δ18O values that range from 5.68‰ to 8.83‰. The Neoproterozoic zircons have variable εHf(t) (−9.2 to +12.5) and δ18O (5.58‰ to 9.85‰) values, whereas the Palaeozoic zircons have εHf(t) values between −19.9 and +13.4 and δ18O values of 5.23‰–9.43‰. The Benxi Formation was deposited during the late Carboniferous and contains sediments derived from igneous rocks of the North Qinling Orogen combined with a small amount of material derived from Precambrian basement of the NCC. The northward subduction of the South Qinling Orogen caused the uplift and erosion of the North Qinling Orogen during the late Carboniferous. [ABSTRACT FROM AUTHOR]

With the aim of constraining the influence of the surrounding plates on the Late Paleozoic–Mesozoic paleogeographic and tectonic evolution of the southern North China Craton (NCC), we undertook new U–Pb and Hf isotope data for detrital zircons obtained from ten samples of upper Paleozoic to Mesozoic sediments in the Luoyang Basin and Dengfeng area. Samples of upper Paleozoic to Mesozoic strata were obtained from the Taiyuan, Xiashihezi, Shangshihezi, Shiqianfeng, Ermaying, Shangyoufangzhuang, Upper Jurassic unnamed, and Lower Cretaceous unnamed formations (from oldest to youngest). On the basis of the youngest zircon ages, combined with the age-diagnostic fossils, and volcanic interlayer, we propose that the Taiyuan Formation (youngest zircon age of 439 Ma) formed during the Late Carboniferous and Early Permian, the Xiashihezi Formation (276 Ma) during the Early Permian, the Shangshihezi (376 Ma) and Shiqianfeng (279 Ma) formations during the Middle–Late Permian, the Ermaying Group (232 Ma) and Shangyoufangzhuang Formation (230 and 210 Ma) during the Late Triassic, the Jurassic unnamed formation (154 Ma) during the Late Jurassic, and the Cretaceous unnamed formation (158 Ma) during the Early Cretaceous. These results, together with previously published data, indicate that: (1) Upper Carboniferous–Lower Permian sandstones were sourced from the Northern Qinling Orogen (NQO); (2) Lower Permian sandstones were formed mainly from material derived from the Yinshan–Yanshan Orogenic Belt (YYOB) on the northern margin of the NCC with only minor material from the NQO; (3) Middle–Upper Permian sandstones were derived primarily from the NQO, with only a small contribution from the YYOB; (4) Upper Triassic sandstones were sourced mainly from the YYOB and contain only minor amounts of material from the NQO; (5) Upper Jurassic sandstones were derived from material sourced from the NQO; and (6) Lower Cretaceous conglomerate was formed mainly from recycled earlier detritus. The provenance shift in the Upper Carboniferous–Mesozoic sediments within the study area indicates that the YYOB was strongly uplifted twice, first in relation to subduction of the Paleo-Asian Ocean Plate beneath the northern margin of the NCC during the Early Permian, and subsequently in relation to collision between the southern Mongolian Plate and the northern margin of the NCC during the Late Triassic. The three episodes of tectonic uplift of the NQO were probably related to collision between the North and South Qinling terranes, northward subduction of the Mianlue Ocean Plate, and collision between the Yangtze Craton and the southern margin of the NCC during the Late Carboniferous–Early Permian, Middle–Late Permian, and Late Jurassic, respectively. The southern margin of the central NCC was rapidly uplifted and eroded during the Early Cretaceous. [ABSTRACT FROM AUTHOR]

This paper reports new whole-rock geochemical, Sr–Nd–Pb isotopic, and zircon U–Pb and Hf isotopic data for Early Cretaceous intrusive rocks in the Sanmenxia–Houma area of central China, and uses these data to constrain the petrogenesis of low-Mg adakitic rocks (LMAR) and the spatial extent of the influence of the deeply subducted Yangtze slab during the Triassic evolution of this region. New zircon laser-ablation inductivity coupled plasma mass spectrometry (LA-ICP-MS) U–Pb data indicate that the early- and late-stage southern Quli, Qiligou, and Gaomiao porphyritic quartz diorites, the Canfang granodiorite, and the northern Wangmao porphyritic quartz monzodiorite were emplaced during the Early Cretaceous (~ 130 Ma) and the late Early Cretaceous (~ 116 Ma). These rocks are characterized by high Na 2 O/K 2 O, Sr/Y, and (La/Yb) n ratios as well as high Sr concentrations, low Mg # [molar 100 × Mg/(Mg + Fe 2 + tot )] values, and low heavy rare earth element and Y concentrations, all of which indicate an LMAR affinity. The samples have relatively high initial 87 Sr/ 86 Sr ratios (0.7054–0.7095), and low ε Nd (t) (− 11.90 to − 22.20) and ε Hf (t) (− 16.7 to − 32.7) values, indicative of a lower continental crust origin. The presence of Neoproterozoic (754–542 Ma) and inherited Late Triassic (220 Ma) metamorphic zircons within the late Early Cretaceous LMAR and the relatively high 206 Pb/ 204 Pb ratios of these rocks suggest that they formed from primary magmas derived from partial melting of Yangtze Craton (YC) basement material that had undergone ultrahigh-pressure metamorphism. In contrast, the presence of Paleoproterozoic and Archean inherited zircons within early Early Cretaceous LMAR in this area and the relatively low 206 Pb/ 204 Pb ratios of these rocks are indicative of derivation from primary magmas generated by partial melting of the thickened lower continental crust of the North China Craton (NCC). These rocks may have formed in an extensional environment associated with the upwelling of asthenospheric mantle material. The presence of YC basement material within the NCC in the Sanmenxia–Houma area suggests that the deeply subducted Yangtze slab influenced an area of ~ 100 km in lateral extent within the southern margin of the central NCC during the Triassic. [ABSTRACT FROM AUTHOR]

AbstractEfferocytosis refers to the process by which phagocytes remove apoptotic cells and related apoptotic products. It is essential for the growth and development of the body, the repair of damaged or inflamed tissues, and the balance of the immune system. Damaged efferocytosis will cause a variety of chronic inflammation and immune system diseases. Many studies show that efferocytosis is a process mediated by mitochondria. Mitochondrial metabolism, mitochondrial dynamics, and communication between mitochondria and other organelles can all affect phagocytes’ clearance of apoptotic cells. Therefore, targeting mitochondria to modulate phagocyte efferocytosis is an anticipated strategy to prevent and treat chronic inflammatory diseases and autoimmune diseases. In this review, we introduced the mechanism of efferocytosis and the pivoted role of mitochondria in efferocytosis. In addition, we focused on the therapeutic implication of drugs targeting mitochondria in diseases related to efferocytosis dysfunction. [ABSTRACT FROM AUTHOR]

Osimertinib, a new-generation inhibitor of the epidermal growth factor, has been used for the clinical treatment of advanced T790M mutation-positive tumors. In this research, an original analysis method was established for the quantification of osimertinib by ultra-performance liquid chromatography with time of flight mass spectrometry (UPLC-TOF-MS) in rat plasma. After protein precipitation with acetonitrile and sorafinib (internal standard, IS), they were chromatographed through a Waters XTerra MS C18 column. The mobile phase was acetonitrile and water (including 0.1% ammonia). The relative standard deviation (RSD) of the intra- and inter-day results ranged from 5.38 to 9.76% and from 6.02 to 9.46%, respectively, and the extraction recovery and matrix effects were calculated to range from 84.31 to 96.14% and from 91.46 to 97.18%, respectively. The results illustrated that the analysis method had sufficient specificity, accuracy and precision. Meanwhile, the UPLC-TOF-MS method for osimertinib was successfully applied into the pharmacokinetics of SD rats. [ABSTRACT FROM AUTHOR]

Apatite is widely utilized to reflect the character and petrogenesis of the parental felsic magma. The compositional variation of apatite from mafic rocks and its applicability to the record of whole-rock are still not well understood. In this study, we present the in situ geochemical analysis of apatite from two types of mafic rocks in the northeastern North China Craton (amphibole-rich mafic rocks for group 1, and pyroxene-rich mafic rocks for group 2). All apatite samples display typically right-sloping rare earth element (REE) patterns, with enrichment in light REE relative to heavy REE, and homogeneous Nd isotopic compositions, suggesting a magmatic origin. Higher apatite REE contents in mafic rocks of group 2 than those of group 1 show a different crystallization sequence in apatite. Extensive apatite crystallization in amphibole-rich mafic rocks, occurs earlier than in pyroxene-rich mafic rocks. The magma differentiation is responsible for the low apatite REE concentrations in group 1 mafic rocks. Combined with previous apatite data, both apatite REE patterns and compositional variations in mafic rocks are mainly controlled by the composition of the original melt. The crystallization of titanite before apatite impoverishes melts in the apatite-compatible trace elements (e.g., middle REE), whereas the crystallization of plagioclase concurrently with apatite can cause some subtle compositional variations of Sr and light REE. Apatite in mafic rocks exhibits higher Sr concentrations than in felsic rocks, which is most likely attributed to the weakening extent of the plagioclase crystallization. [Display omitted] • Apatite compositions in mafic rocks mainly depend on the parental melt. • Apatite grains from appinite crystallize earlier than those from gabbro. • The crystallization of mineral phases can cause apatite compositional variations. [ABSTRACT FROM AUTHOR]

To study the mechanical characteristics and the damage evolution process of coal under direct tensile loads, the direct tensile tests and real-time acoustic emission (AE) tests on raw coal specimens were conducted using MTS815 rock mechanics testing system and PCI-1I AE testing system. In addition, the direct tensile mechanical characteristics and the AE property of coal were analyzed and a damage model of coal based on AE was built. The test results show that the tensile strengths of specimens, whose average tensile strength is 0.66 MPa, are obviously discrete because of the variations of defect distribution in coal specimens. Under direct tensile loading conditions, the post-peak bearing capacity of specimen decreases due to the damage accumulation, but does not directly reach zero. The AE events increase and converge dramatically along the failure surface, which indicates the formation of macroscopic crack surface and the occurrence of coal destruction at the peak stress zoon. As the specimen destruction process gradually advances, the AE count rate and the AE energy rate increase and decrease repeatedly at the post-peak region. The AE tests can demonstrate the complete evolution process of coal damage under direct tensile loading conditions: occurrence, development and destruction. [ABSTRACT FROM AUTHOR]

To discuss the effects of coal-rock combination mode on its mechanical and damaging characteristics, the uniaxial and triaxial compressive tests for three combination modes, such as Rock-Coal-Rock ( YMY), Rock-Coal (YM) and Coal-Rock (MY) ,were carried out on MTS815 Rock Mechanics Testing System. The results show that the failure mainly concentrates on the coal part of combination specimen, and do not be affected by the combining mode and the loading condition. The development of damage and increase of failure extent in coal part can result in the emergence of damage and failure in rock part to some extent. The failure states are mainly tensile failure and happens in coal part for uniaxial compressive test. The uniaxiaI compressive strength of YMY is 40.03 MPa, which is 1.80 and 1.53 times of YM and MY, respectively. Under triaxial compressive condition, the failure are all mainly shear failure in coal part, and the average triaxial strength for three, combination modes gradually approaches with the confining pressure increasing. [ABSTRACT FROM AUTHOR]

The topsoil cyanobacteria in biological soil crusts (BSCs) play a vital role in stabilizing soil surface of disturbed habitats in water and nutrient-poor ecosystems. Currently, artificial inoculation of BSCs is considered as an effective approach to restore habitats and accelerate ecosystem regeneration. Understanding the character of cyanobacterial communities is the necessary prerequisite to explore the artificial inoculation of BSCs. For this reason, cyanobacterial communities in BSCs were compared between two mid-latitute temperate deserts with distinct precipitation patterns. The results showed that Oscillatoriales and Nostocales dominated crusts in the Tengger desert with majority of rainfall in summer and early autumn while Oscillatoriales dominated crusts in the Kyzyl kum desert with more rainfall in winter and early spring. Moreover, filamentous Microcoleus vaginatus overwhelmingly dominated all the crusts in both deserts with Mastigocladopsis sp. and Chroococcidiopsis spp. as the dominant heterocystous cyanobacteria. Of note, genus Wilmottia kept a relative stable and high abundance in both deserts. The top two abundantly shared cyanobacteria (> 1% of total sequences) were M. vaginatus and Mastigocladopsis sp. in both deserts, while 16 genera with significant variances were found between the two deserts (P <0.05). Total variations of cyanobacterial communities across the deserts were largely explained by a combination of biotic factors (microbial biomass C and N) and abiotic factors (soil pH, soil water content, soil water holding capacity, and soil available potassium). Compared to better-developed crusts, cyanobacterial abundance was higher in cyanobacterial crusts. BSC type and/or geographic location significantly affected cyanobacterial Shannon diversity without significantly influencing species richness. Our data suggest that the basic and major groups (e.g. M. vaginatus , Wilmottia spp., Mastigocladopsis sp., and Chroococcidiopsis spp.), and the abundantly shared phylotypes which showed significant difference in cyanobacterial communities between deserts, should be focused on to further explore the artificial inoculation of BSCs in temperate drylands. Unlabelled Image • Cyanobacteria in BSCs were compared between deserts with distinct rainfall patterns. • M. vaginatus predominated all the crusts in both temperate deserts. • Cyanobacterial absolute abundance was lower in better-developed BSCs. • BSC type and/or geographic location significantly affected Shannon diversity. • M. vaginatus , Wilmottia , Mastigocladopsis and Chroococcidiopsis are potential efficient inoculums. [ABSTRACT FROM AUTHOR]

Background: Acute kidney injury (AKI) is a common complication after surgery and is associated with detrimental outcomes. This systematic review and meta-analysis evaluated perioperative dexmedetomidine on AKI and renal function after non-cardiac surgery., Methods: PubMed, Embase, and Cochrane Library databases were searched until August 2023 for randomised trials comparing dexmedetomidine with normal saline on AKI and renal function in adults undergoing non-cardiac surgery. The primary outcome was the incidence of AKI (according to Kidney Disease Improving Global Outcomes or Acute Kidney Injury Network criteria). Meta-analysis was performed using a random-effect model. We conducted sensitivity analysis, trial sequential analysis (TSA), and Grading of Recommendations Assessment, Development and Evaluation level of evidence., Results: Twenty-three trials involving 2440 patients were included. Dexmedetomidine administration, as compared to normal saline, significantly reduced the incidence of AKI (7.4% vs. 13.2%; risk ratio = 0.57, 95% CI = 0.40-0.83, P =  0.003, I 2  = 0%; a high level of evidence); TSA and sensitivity analyses suggested the robustness of this outcome. For the renal function and inflammation parameters, dexmedetomidine decreased serum creatinine, blood urea nitrogen, cystatin C, tumour necrosis factor-α, and interleukin-6, and increased urine output and estimated glomerular filtration rate. Additionally, dexmedetomidine reduced postoperative nausea and vomiting and length of hospital stay. Dexmedetomidine was associated with an increased rate of bradycardia, but not hypotension., Conclusion: Dexmedetomidine administration reduced the incidence of AKI and improved renal function after non-cardiac surgery. Based on a high level of evidence, dexmedetomidine is recommended as a component of perioperative renoprotection., Registration: International Prospective Register of Systematic Reviews; Registration number: CRD42022299252., (Copyright © 2024 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.)