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Background Acute kidney injury (AKI) is a common complication after pediatric cardiac surgery and is associated with worse outcomes. Ibuprofen is widely used in the perioperative period and can affect kidney function in children. However, the association between ibuprofen exposure and AKI after pediatric cardiac surgery has not been determined yet.Methods In this retrospective cohort study, children undergoing cardiac surgery with cardiopulmonary bypass were studied. Exposure was defined as given ibuprofen in the first 7 days after surgery. Postoperative AKI was diagnosed using the KDIGO criteria. A multivariable Cox regression model was used to assess the association between ibuprofen exposure and postoperative AKI by taking ibuprofen as a time-varying covariate.Results Among 1,112 included children, 198 of them (17.8%) experienced AKI. In total, 396 children (35.6%) were exposed to ibuprofen. AKI occurred less frequently among children who were administered ibuprofen than among those who were not (46 of 396 [11.6%] vs. 152 of 716 [21.2%], p

Background: Hepatosteatosis is a common condition that can lead to cirrhosis and liver cancer. Galectin-3 (GAL-3) has been implicated in liver fibrosis and inflammation. Objectives: The purpose of this study was to investigate the association between GAL-3 and hepatosteatosis. Design: This study is a retrospective secondary analysis of data from a community health screening program. Methods: A total of 766 participants were included in the final analysis. Hepatosteatosis was diagnosed using ultrasonography, and GAL-3 levels were measured using enzyme-linked immunosorbent assay. Logistic regression analysis was used to examine the association between GAL-3 levels and the presence of hepatosteatosis, adjusting for age, sex, and other potential confounding factors. Results: The prevalence of moderate-to-severe hepatosteatosis in the study population was 31.5%. The participants with hepatosteatosis had a significantly higher mean level of GAL-3 compared to those without hepatosteatosis (16.6 ± 7.3 vs 13.5 ± 7.3 ng/ml; p 1 and GAL-3 >14.4 ng/ml was associated with a significantly increased risk (aOR 3.37, 95% CI: 1.90–5.99, p

IntroductionAtherosclerotic cardiovascular disease is associated with a high mortality rate due to vascular calcification. The role of fetuin-A in aortic arch calcification (AAC) is less well understood.MethodsAn analysis of secondary biomarkers was performed on 800 individuals from the biobank using the community database. AAC was defined by radiologists based on imaging. Multiple variables logical analysis was used for risk analysis.ResultsA total of 736 individual samples were collected based on age and gender. The average age is 65 ± 10 years, and half the population comprises men. In spite of similar body weight, renal function, and hepatic function, the AAC group had higher blood pressure and fetuin-A levels independently: systolic blood pressure (SBP) index ≥130 mmHg [adjusted odds ratio (aOR) 1.85, 95% confidence interval (CI) 1.34–2.57, p = 0.002] and fetuin-A (aOR 0.62, 95% CI 0.50–0.76, p

Pressure monitoring of a transformer oil tank can grasp the pressure change process caused by gas production when severe internal defects occur and take timely measures to ensure the safe operation of the transformer. Existing pressure sensors generally use metal encapsulation or have an air cavity structure, threatening the transformer's insulation if it is directly used inside the transformer. To this end, this paper proposes a method for developing a high-sensitivity, large-range, and metallization-free optical pressure sensing device with temperature compensation. Fiber grating is encapsulated by fluorosilicone rubber and supplemented by an epoxy resin shielding shell on the outside. At the same time, a double-grating vertical arrangement is adopted to improve pressure measurement sensitivity, further avoiding the influence of temperature rise caused by a defect of the transformer on the measurement result of the sensor. In addition, by optimizing the geometric structure of the internal sensitizing element, pre-stretching length of the fiber grating, gap distance, and other parameters, probe size can be reduced while ensuring the sensor's performance. Results show the proposed method can meet the requirements of sensor fabrication with different sensitivities and ranges, and to a certain extent, both high sensitivity and extensive ranges can be taken into account. The sensitivity of the fabricated prototype is 15 pm/kPa, and the range is about 0.2 MPa. At the same time, the metal-free feature of the sensor makes it suitable for use in various oil-immersed power equipment. It records oil pressure changes caused by oil discharge breakdown, making it sensitive to small pressure changes in early failures.

In this paper, we investigate a perturbed elliptic boundary value problem that exhibits critical growth characterized by a Trudinger–Moser-type inequality. Our primary focus is to establish the existence of two nontrivial solutions. This is achieved by employing a combination of the Trudinger–Moser-type inequality and a linking theorem based on the Z2-cohomological index. The main feature and novelty of this paper lies in extending the equation to N-Laplacian boundary value problems utilizing the aforementioned methods. This extension not only broadens the applicability of these techniques but also enriches the research outcomes in the field of nonlinear analysis.

The accumulation of senescent cells in kidneys is considered to contribute to age-related diseases and organismal aging. Mitochondria are considered a regulator of cell senescence process. Atrazine as a triazine herbicide poses a threat to renal health by disrupting mitochondrial homeostasis. Melatonin plays a critical role in maintaining mitochondrial homeostasis. The present study aims to explore the mechanism by which melatonin alleviates atrazine-induced renal injury and whether parkin-mediated mitophagy contributes to mitigating cell senescence. The study found that the level of parkin was decreased after atrazine exposure and negatively correlated with senescent markers. Melatonin treatment increased serum melatonin levels and mitigates atrazine-induced renal tubular epithelial cell senescence. Mechanistically, melatonin maintains the integrity of mitochondrial crista structure by increasing the levels of mitochondrial contact site and cristae organizing system, mitochondrial transcription factor A (TFAM), adenosine triphosphatase family AAA domain-containing protein 3A (ATAD3A), and sorting and assembly machinery 50 (Sam50) to prevent mitochondrial DNA release and subsequent activation of cyclic guanosine 5′-monophosphate–adenosine 5′-monophosphate synthase pathway. Furthermore, melatonin activates Sirtuin 3–superoxide dismutase 2 axis to eliminate the accumulation of reactive oxygen species in the kidney. More importantly, the antisenescence role of melatonin is largely determined by the activation of parkin-dependent mitophagy. These results offer novel insights into measures against cell senescence. Parkin-mediated mitophagy is a promising drug target for alleviating renal tubular epithelial cell senescence.

Introduction Dysmagnesemia has been demonstrated to be involved in the pathophysiology of kidney diseases and is common in cardiac surgical patients. It remains unknown whether changes of serum magnesium after cardiac surgery affect AKI. We aimed to investigate the association of early postoperative magnesium with cardiac surgery-associated AKI in adults.Methods We conducted a multicenter retrospective cohort study involving patients who underwent cardiac surgery in the eICU Collaborative Research Database between 2014 and 2015. AKI within 7 days after surgery was defined using both serum creatinine and urine output criteria of Kidney Disease Improving Global Outcomes definition. Postoperative AKI was analyzed using multivariable logistic regression with early postoperative serum magnesium measured within the first 24 h after surgery as a continuous variable and categorically by quartiles.Results Postoperative AKI was identified in 3498 of 6124 (57.1%) patients receiving cardiac surgery. The median (25th–75th percentiles) early postoperative serum magnesium level of the study population was 2.3 (2.0–2.7) mg/dL. Higher serum magnesium level was associated with a higher risk of developing postoperative AKI (adjusted odds ratio (OR), 1.46 per 1 mg/dL increase; 95% confidence interval (CI), 1.31–1.62; p

Photodynamic therapy (PDT) is a non-invasive cancer therapy method that has been clinically approved formany years. Due to strong optical scattering and absorption of tissues, optical photons can only penetratetissues several millimetres, which limits the applications of PDT to superficial lesions. To overcome thelimitation of penetration depth, here we applied Cerenkov radiation, as generated by the high-energy -raysfrom radionuclide Cesium-137, to directly activate the porphyrin-based photosensitizer MPPa(Pyropheophorbide-a methyl ester) without any additional energy mediators. Experiments were conductedwith A549 human lung carcinoma cell line. Moreover, to reduce the effects of possible plastic scintillationon PDT, we used black cell culture plates in these studies. We have also shown that the effects of thescintillations on PDT could be minimized. In our studies, we have excluded the effects of radiotherapy anddrug toxicity. Our results indicated that the Cerenkov radiation generated from high energy -rays could beused to activate the photosensitizer MPPa in PDT, which could potentially overcome the penetrationlimitations of optical photon-based PDT, making the PDT a feasible and complementary cancer therapy fordeep lesions.

Abstract Sarcopenia has been associated with conventional chemotherapy-related toxicity, postoperative complications and poor overall survival in patients with genotype-unselected metastatic colorectal cancer (mCRC). This study aimed to evaluate the prognostic implications of sarcopenia and its change after perioperative cetuximab plus doublet chemotherapy and hepatectomy in patients with RAS wild-type colorectal liver metastasis (CRLM). Patients with CRLM from 2007 to 2018 in Chang Gung Research Database were retrospectively analyzed. Baseline characteristics as well as skeletal muscle index (SMI) at baseline and dynamic changes after interventions were collected. A multivariate Cox proportional hazard model was used to evaluate the effect of each parameter on overall survival (OS), and the Kaplan–Meier method was used to establish survival curves. A two-sided p value

Fabrication of silicon carbide (SiC) ceramics by digital light processing (DLP) technology is difficult owing to high refractive index and high ultraviolet (UV) absorptivity of SiC powders. The surface of the SiC powders can be coated with silicon oxide (SiO2) with low refractive index and low UV absorptivity via high-temperature oxidation, reducing the loss of UV energy in the DLP process and realizing the DLP preparation of the SiC ceramics. However, it is necessary to explore a high-temperature modification process to obtain a better modification effect of the SiC powders. Therefore, the high-temperature modification behavior of the SiC powders is thoroughly investigated in this paper. The results show that nano-scale oxide film is formed on the surface of the SiC powders by short-time high-temperature oxidation, effectively reducing the UV absorptivity and the surface refractive index (nʹ) of the SiC powders. When the oxidation temperature is 1300 ℃, compared with that of unoxidized SiC powders, the UV absorptivity of oxidized SiC powders decreases from 0.5065 to 0.4654, and a curing depth of SiC slurry increases from 22±4 to 59±4 μm. Finally, SiC green bodies are successfully prepared by the DLP with the the oxidized powders, and flexural strength of SiC sintered parts reaches 47.9±2.3 MPa after 3 h of atmospheric sintering at 2000 ℃ without any sintering aid.

The most important secondary resources of platinum group metals (PGMs) are spent automotive exhaust catalysts, which are called “mobile PGM mines.” Low-temperature iron-capture technology is a promising technology for recovering PGMs due to its high efficiency and low pollution. Because of the content of aluminosilicates and toxic heavy metals (Cr, Ba, Ni, and Mn), the disposal of iron-capture smelting slag is necessary. This paper is devoted to the solidification of heavy metals and the resource utilization of iron-capture smelting slag. Glass-ceramics were made by a one-step method using aluminosilicates as network formers. Heavy metals and CaF2 are employed as nucleating agents in pickling sludge. According to the analysis of differential scanning calorimetry, the glass transition temperature and crystallization temperature of samples are in the range of 650 ℃–700 ℃ and 800 ℃–920 ℃, respectively. The gap between the glass transition temperature and crystallization temperature of samples decreased from 211 ℃ to 150 ℃ when increasing the amount of pickling sludge from 7% to 28% (mass fraction). The devitrification activation energy decreased from 321.8 to 303.5 kJ·mol−1, while the Avrami index increased from 1.7 to 3.7. It demonstrates that pickling sludge can reduce the temperature difference between nucleation and crystallization, which is beneficial in realizing the one-step process. The effects of pickling sludge and heat treatment systems on glass-ceramics were investigated. The diopside phase is the main crystalline phase of glass-ceramics. Nepheline and Magnetite phases were detected when the amount of pickling sludge (mass fraction) reached 28%. The physical properties of the glass-ceramics were improved with the increase in heat treatment temperature and time. When the addition amount of pickling sludge (mass fraction) was 21%, the glass-ceramics prepared by heat treatment at 900 ℃ for 1.2 h had the best properties; namely, the density was 3.04 g·cm−3, the water absorption (mass fraction) was 0.11%, and the Vickers hardness and flexural strength were 742.72 HV and 119.32 MPa, respectively. The Toxicity Characteristic Leaching Procedure (TCLP) leaching standard was met by heavy metals such as Cr, Ba, and Ni in the toxicity test. Glass structure analysis revealed that the pickling sludge increased the nonbridging oxygen content in the base glass while reducing the degree of glass network polymerization, resulting in an enhanced crystallization tendency. The pickling sludge proved to have potential as an inexpensive nucleating agent in the preparation of glass-ceramics with excellent performance. The glass-ceramics with these unique properties are promising to be applied as building materials.

Background: Thrombocytopenia is a common extrahepatic manifestation in chronic liver disease. However, there have been rare studies of impacts of risk for hepatitis C virus-associated thrombocytopenia (HCV-TP) and hepatitis B virus-associated thrombocytopenia (HBV-TP). The aim of this study is to evaluate different impacts of risk factors for HCV-TP and HBV-TP. Methods: We retrospectively collected 1803 HCV patients and 1652 HBV patients to examine the risk factors for time to moderate and severe thrombocytopenia (platelet counts

ObjectiveCentral precocious puberty (CPP) is a rare condition that causes early sexual development in children. Although the cure is effective, the etiology of central precocious puberty is unclear.MethodsIn total, 10 girls with central precocious puberty and same number of age-matched female controls were enrolled. Plasma samples were collected from each participant and subjected to untargeted metabolomics and lipidomics. Student's t-tests were employed to compare the mean of each metabolite and lipid. Furthermore, orthogonal partial least-squares discriminant analysis was conducted and the variable importance in the projection was calculated to identify differentially expressed metabolites or lipids. Subsequent bioinformatics was conducted to investigate the potential function of differentially expressed metabolites and lipids.ResultsFifty-nine differentially expressed metabolites were identified based on the criteria used (variable importance in the projection >1 and a P value

Abstract Background Mechanical stress plays a crucial role in the pathogenesis of intervertebral disc degeneration (IVDD). The mechanosensitive Piezo1 ion channel can sense the changes in mechanical stress and convert the mechanical signals into chemical signals. This study aims to investigate the effect of Piezo1 on the mechanical stress-induced IVDD and explore the possible mechanism. Methods The expression of Piezo1 and collagen II in immunohistochemical staining, cervical curvature, and the stiffness of nucleus pulpous (NP) were performed in normal and degenerated human intervertebral discs. In the experiment, high-intensity compression was applied to mimic the mechanical environment of IVDD. The cell viability, matrix macromolecules, and pro-inflammatory cytokines were examined to investigate the effect of Piezo1 on mechanical stress-treated NP cells. Additionally, autophagy condition of NP cells was detected within high-intensity compression and/or the inhibitor of Piezo1, GsMTx4. Results The up-expression of Piezo1, down-expression of Col II, elevated stiffness of NP, and poor kyphosis were observed in degenerated human intervertebral discs. High-intensity stress significantly decreased cell viability and the synthesis of extracellular matrix but increased the expression of senescence-associated proteins (p53 and p16) and pro-inflammatory cytokines (TNF-α, IL-6 and IL-1β) by mitochondrial dysfunction and suppression of autophagy. However, GsMTx4 can partly attenuate these effects. Conclusion Piezo1 upregulation under excessive mechanical stress promotes the apoptosis, senescence, and pro-inflammatory cytokines of NP and leads to the loss of extracellular matrix by mitochondrial dysfunction and the suppression of autophagy; on the other hand, the inhibition of Piezo1 can partly alleviate these effects.

AIM:To investigate the factors associated with short-term elevation of intraocular pressure(IOP)after conbercept intravitreal injection. METHODS:This study was a clinical prospective observational study. It enrolled in 269 eyes of 269 patients who were diagnosed retinopathy, and all patients receive conbercept intravitreal injection. Among them, 143 were males and 126 were females. There were 201 cases of age-related macular degeneration(ARMD)and 68 cases of other retinopathy patients. The mean age was 62.86±11.74 years. Non-contact pneumatic tonometer was used to measure the IOP of the patients before, 10, 30min, 2 and 4h after injection. The group was divided according to the IOP elevation 10min after injection. The IOP elevation 10 mmHg and above was defined as the IOP elevation group, and the IOP elevation less than 10 mmHg was defined as the IOP stable group. Multivariate Logistic regression analysis was used to analyze the differences between the two groups.RESULTS:The average IOP of patients at 10, 30min, 2 and 4h after injection was 24.1, 20.2, 19.5 and 16.9 mmHg, respectively. The average IOP at each time point after injection was 6.7, 3.1, 1.7 and 0.5 mmHg higher than that before injection. Among them, 56 cases of increased IOP, 213 cases of stable IOP. There were no significant differences in age, best corrected visual acuity(BCVA), gender, eye side and disease type between two groups(all P>0.05). There were statistically significant differences in the number of injection(Z=-4.389, P=0.012), IOP before injection and IOP at each time point after injection(t=-5.343, -10.467, -8.933, -6.124, -4.635, all P

A three‐component cyclization reaction of O‐acyl oximes, silyl enol ethers and elemental sulfur has been developed, in which silyl enol ether acts as a C1 synthon to participate in cyclization reaction and build a series of 2‐aroylnaphthothiazoles and 2‐aroylbenzothienothiazoles. The preliminary exploration of the reaction mechanism indicated that this transformation probably proceeded through a radical process, involving S3⋅− as a key intermediate, enabling subsequent nucleophilic substitution with O‐acyl oximes to afford iminosulfur radical, which undergoes 1,3‐H shift to yield sulfur‐centered radical intermediate. And then this intermediate undergoes radical addition with silyl enol ether, leading to the formation of the titled products through intramolecular cyclization and oxidation. Moreover, the products obtained exhibit favorable fluorescence properties, which indicates their potential application as functional materials. [ABSTRACT FROM AUTHOR]

This study investigated the prevalence and occurrence of 3-monochloropropanediol esters (3-MCPDEs) and glycidyl esters (GEs) in domestically and commercially prepared food in Singapore and assessed the total dietary exposure for the Singaporean population. Minimal impact on the formation of 3-MCPDEs and GEs was observed from the domestic cooking methods commonly practiced in Singapore such as deep frying and stir frying. The estimated total dietary exposure to 3-MCPDEs for the Singaporean population (aged 15 to 92) was 0.982 µg/kg bw/day for general consumers and 2.212 µg/kg bw/day for high consumers (95th percentile), which accounted for 49.1% and 110.6% of the tolerable dietary intake (TDI) at 2 µg/kg bw/day by the European Food Safety Authority (EFSA). The calculated margins of exposure (MOE) for GEs based on the dietary exposure for general consumers at 0.882 µg/kg bw/day and 2.209 µg/kg bw/day for high consumers were below 10,000, indicating a potential health concern. Our study showed that the occurrence of 3-MCPDEs and GEs varied among vegetable oils, and domestic cooking methods did not significantly impact the levels of 3-MCPDEs and GEs in prepared food. The critical factor influencing the prevalence and occurrence of 3-MCPDEs and GEs was the choice of oil used for cooking, which absorbed into the cooked food. It is essential to encourage the food industry to continue its innovation on mitigation measures to control and reduce 3-MCPDEs and GEs in vegetable oil production. Consumers are advised to make informed choices on food consumption and cooking oil for food preparation to reduce their exposure to 3-MCPDEs and GEs.

Background Human platelet antigens (HPAs) are alloantigens for antiplatelet alloantibodies and associated with the risk of immune thrombocytopenia (ITP). However, few studies have investigated associations among HPAs, antiplatelet autoantibodies, and cryoglobulins. Methods We enrolled 43 patients with primary ITP, 47 with hepatitis C virus-associated ITP (HCV-ITP), 21 with hepatitis B virus-associated ITP (HBV-ITP), 25 controls with HCV, and 1013 normal controls including HPA data of 998 Taiwanese blood donors. We analyzed HPA allele frequencies including HPA1-6 and 15, antiplatelet antibodies binding to platelet glycoprotein (GP) IIb/IIIa, Ia/IIa, Ib/IX, IV, human leukocyte antigen class I, cryoglobulin IgG/A/M, and their associations with thrombocytopenia. Results In the whole ITP cohort, HPA2ab predicted a low platelet count. HPA2b was associated with the risk of developing ITP, but not with anti-GPIb/IX antibodies. HPA15b was correlated with multiple antiplatelet antibodies. In the primary ITP patients, HPA3b was correlated with cryoglobulin IgG/A/M. In contrast, in the HCV-ITP patients, HPA3b was correlated with anti-GPIIb/IIIa antibodies, HCV-ITP patients with anti-GPIIb/IIIa antibodies had a higher positive rate of cryoglobulin IgG and IgA caomparred with those without anti-GPIIb/IIIa antibodies. Similar to the antiplatelet antibodies, cryoglobulins were associated with clinical thrombocytopenia, especially cryoglobulin IgA. Furthermore, cryoglobulins in the HCV-ITP patients showed characteristics to antiplatelet antibodies. Conclusion HPA alleles were associated with antiplatelet autoantibodies but had different impacts in the patients with primary ITP and HCV-ITP. The pathophysiology and characteristics of antiplatelet antibodies were different between these two groups. HCV-ITP was considered to be a symptom of mixed cryoglobulinemia in the HCV patients.

Contrast-enhanced ultrasound (CEUS) is a new form of ultrasound (US) that can dynamically display microvessels in a highly sensitive manner. The purpose of this study was to investigate the efficacy of CEUS for characterizing testicular lesions in comparison with conventional US. Forty-seven patients with testicular lesions were enrolled. The histopathology results revealed that 31 cases were neoplastic (11 cases of seminomas, 8 nonseminomatous germ cell tumors, 8 lymphomas, 2 Leydig cell tumors, and 2 nonspecific tumors), and 16 cases were nonneoplastic (8 cases of infarctions, 3 epidermoid cysts, and 5 inflammation). The indicators of shallow lobulated morphology and cystic-solid echogenicity on conventional US were suggestive of germ cell tumors. More indicators on CEUS were found to be useful for characterizing testicular lesions. All the neoplastic lesions showed hyperenhancement on CEUS. Moreover, germ cell tumors presented with heterogeneous enhancement (73.7%, 14/19), a twisted blood vessel pattern, rapid wash-in and wash-out, and peripheral rim hyperenhancement signs. Lymphoma was characterized by nonbranching linear vessel patterns (87.5%, 7/8), rapid wash-in and slow wash-out. In nonneoplastic lesions, infarction and epidermoid cysts showed no enhancement, and abscesses were observed with marginal irregular enhancement. The sensitivity, specificity, and accuracy of CEUS for differentiating between neoplastic and nonneoplastic lesions were 100%, 93.8%, and 97.9%, respectively, and these values were higher than those for conventional US (90.3%, 62.5%, and 80.9%, respectively). CEUS can sensitively reflect the microvascular perfusion in testicular lesions and offers high accuracy for characterizing them.

Hepatitis C virus-associated immune thrombocytopenia (HCV-ITP) has been assumed to be one of secondary ITP and associated with antiplatelet antibodies. This study was to clarify the antibody profile in HCV-ITP compared with primary ITP. We enrolled 55 HCV-ITP, 30 primary ITP, 11 Helicobacter pylori-ITP, 21 HCV control, and 16 healthy volunteers. We reviewed their blood cell counts, autoimmune markers, and spleen size. We used enzyme-linked immunosorbent assay kit to detect the specific antibody to glycoproteins IIb/IIIa, Ia/IIa, Ib/IX, IV, and human leukocyte antigen (HLA) class I. Compared with primary ITP patients, HCV-ITP patients had an older age, lower white blood cell (WBC) count and fewer presented with severe thrombocytopenia. The rate of positive antibody detection was 63.6% for the HCV-ITP group higher than the rate of 40% for the primary ITP. In the HCV control, antiplatelet antibodies were detected in 38.1% patients and no one had more than two types of antibodies. The antiplatelet antibodies correlated to severer thrombocytopenia. An HLA class I antibody was associated with lower WBCs and larger spleen. In conclusion, HCV-ITP patients had a high rate of positive antiplatelet antibody. The antibodies were associated with not only lower platelets but also leukopenia and splenomegaly.

BackgroundIntraoperative transfusion is associated with adverse clinical outcomes in cardiac surgery. However, few studies have shown the impact of intraoperative red blood cell (RBC) transfusion on non-anemic patients undergoing cardiac surgery. We assessed the in-hospital clinical outcomes of non-anemic patients undergoing isolated valve replacements and investigated the predictors associated with intraoperative RBC transfusion.MethodsWe enrolled 345 non-anemic patients undergoing isolated valve replacements in our department from January 2015 to December 2019. The patients were stratified by the receipt of intraoperative RBC transfusion. Baseline characteristics were compared between groups and multiple logistic regression was used to identify the predictors for intraoperative RBC transfusion. The association between intraoperative RBC transfusion and in-hospital outcomes was also evaluated.ResultsIntraoperative RBC transfusion developed in 84 of the 345 enrolled patients (24.3%). Three independent predictors for intraoperative RBC transfusion of non-anemic patients undergoing isolated valve replacements were identified by multivariate logistic analysis, including female, iron deficiency and hemoglobin level. When the two groups were compared, a significant tendency of higher in-hospital mortality (6.0% vs. 1.1%, P = 0.033) and higher incidence of postoperative hypoxemia (9.5% vs. 2.7%, P = 0.007) were observed in the intraoperative RBC transfusion group. After adjustment, the presence of intraoperative RBC transfusion was associated with an increase in postoperative hypoxemia (OR = 3.36, 95% CI: 1.16–9.71, P = 0.026).ConclusionIntraoperative RBC transfusion was associated with poorer clinical outcomes in non-anemic adults undergoing isolated valve replacements, which significantly increased the risk of postoperative hypoxemia. The independent predictors of intraoperative RBC transfusion, such as iron deficiency and female, were identified, which may be helpful for risk assessment and perioperative management.

Background: Aortic stenosis (AS) increases left ventricular afterload, leading to cardiac damage and heart failure (HF). Transcatheter aortic valve replacement (TAVR) is an effective therapy for AS. No inotropic agents including levosimendan have been evaluated in patients undergoing TAVR.Methods: A total of 285 patients underwent TAVR between 2014 and 2019; 210 were included in the matched analysis and 105 received 0.1 μg/kg body weight/min levosimendan immediately after the prosthesis had been successfully implanted. Medical history, laboratory tests, and echocardiography results were analyzed. Endpoints including 2-year all-cause mortality, stroke, or HF-related hospitalization, and a combination of the above were analyzed by Cox proportional hazard models.Results: The levosimendan group had no difference in 2-year mortality compared with the control group (hazard ratio [HR]: 0.603, 95% confidence interval [CI]: 0.197–1.844; p = 0.375). However, levosimendan reduced stroke or HF-related hospitalization (HR: 0.346; 95% CI: 0.135–0.884; p = 0.027) and the combined endpoint (HR: 0.459, 95% CI: 0.215–0.980; p = 0.044). After adjusting for multiple variants, levosimendan still reduced stroke or HF-related hospitalization (HR: 0.346, 95% CI: 0.134–0.944; p = 0.038).Conclusion: Prophylactic levosimendan administration immediately after valve implantation in patients undergoing TAVR can reduce stroke or HF-related hospitalization but does not lower all-cause mortality.

This study investigated the influence of ‘snackification’ in Singaporean diets, leading to increased dietary acrylamide exposure. Acrylamide concentrations in commonly consumed foods within and outside the main meals were measured using liquid chromatography with tandem mass spectrometry (LC-MS/MS). High acrylamide concentrations were detected in vegetables cooked at high temperatures (ranging from 0.5 to 478.4 µg/kg) and potato-based crackers and chips (ranging from 81.8 to 2095.8 µg/kg). The estimated total dietary exposure for the Singapore population was 0.165 µg/kg bw/day for general consumers and 0.392 µg/kg bw/day for high consumers (95th percentile). The acrylamide exposure from outside main meals was nearly equivalent to that from within the main meals. The calculated margins of exposure (MOE) were below 10,000, indicating potential human health concern. These findings highlight the need for industry practices and consumer advisories to reduce acrylamide exposure from foods consumed both within and outside main meals.

Abstract Background Evidence for peritoneal dialysis catheter (PDC) usage in pediatric patients undergoing surgery for deteriorating cardiac dysfunction is lacking. This investigation explored factors associated with PDC usage and its effectiveness in children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). Methods Eighty-four children undergoing left coronary artery transfer were retrospectively recruited. The primary endpoint was the postoperative ratio of the general ward/[intensive care unit (ICU)] length of stay. Univariable and multivariable analyses were fitted to assess factors related most strongly to PDC and the ratio of general ward/ICU length of stay. Results Of the 84 patients, 17 (20.2%) underwent postoperative PDC placement. Patients with extreme cardiac dysfunction [left ventricular ejection fraction (LVEF) ≤25%] were much more likely to require a PDC (OR, 9.88; 95% CI, 2.13–45.76; P = 0.003). Moreover, univariate analysis indicated that concomitant mitral repair significantly decreased the likelihood of PDC placement (OR, 0.25; 95% CI, 0.07–0.85; P = 0.026). In those with cardiac dysfunction (LVEF ≤50%), PDC use was associated with a reduced ratio of ward/ICU length of stay (B, − 1.62; 95% CI, − 2.77– -0.46; P = 0.008), as was age ≤ 12 months (B, − 1.57; 95% CI, − 2.88– -0.26; P = 0.02). At the 1-year follow-up, cardiac improvement was significantly greater in patients with PDC usage than in those without it (P

Abstract Introduction The most striking feature of depression is sadness and a loss of interest in activities, which represents a major cause of disability globally. Therefore, it is necessary to identify novel antidepressants for clinical practice. Ginsenoside Rh2 (Rh2) is one of the major bioactive ginsenosides that can be extracted from Panax ginseng and has been demonstrated to improve both memory and learning. The purpose of this study was to provide broad insight into the mechanisms underlying depression and gain greater insights into antidepressant therapy. Methods In this study, we first established an effective and feasible depression animal model of chronic unpredictable mild stress (CUMS) and behavioral testing was evaluated by the forced swim test (FST), the tail suspension test (TST) and the sucrose preference test. Following pretreatment with Rh2 (10 and 20 mg/kg), the immobility time of mice was reduced without affecting locomotor activity in both the FST and TST. Western blotting and immunofluorescence were used to investigate the activation of the hippocampal BDNF signaling pathway and hippocampal neurogenesis. Results Different concentrations of Rh2 significantly reduced depressive‐like symptoms in CUMS‐induced mice and downregulated the effects of the BDNF signaling cascade and neurogenesis in the hippocampus. Furthermore, the administration of K252a completely prevented the antidepressant‐like activity of Rh2 in mice. Conclusion The results indicated that Rh2 possesses the antidepression action via the positive regulation of the BDNF‐TrkB pathway.