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BACKGROUND: We developed machine learning models that combine preoperative and intraoperative risk factors to predict mortality after cardiac surgery. METHODS: Machine learning involving random forest, neural network, support vector machine, and gradient boosting machine was developed and compared with the risk scores of EuroSCORE I and II, Society of Thoracic Surgeons (STS), as well as a logistic regression model. Clinical data were collected from patients undergoing adult cardiac surgery at the First Medical Centre of Chinese PLA General Hospital between December 2008 and December 2017. The primary outcome was post-operative mortality. Model performance was estimated using several metrics, including sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (AUC). The visualization algorithm was implemented using Shapley’s additive explanations. RESULTS: A total of 5,443 patients were enrolled during the study period. The mean EuroSCORE II score was 3.7%, and the actual in-hospital mortality rate was 2.7%. For predicting operative mortality after cardiac surgery, the AUC scores were 0.87, 0.79, 0.81, and 0.82 for random forest, neural network, support vector machine, and gradient boosting machine, compared with 0.70, 0.73, 0.71, and 0.74 for EuroSCORE I and II, STS, and logistic regression model. Shapley’s additive explanations analysis of random forest yielded the top-20 predictors and individual-level explanations for each prediction. CONCLUSIONS: Machine learning models based on available clinical data may be superior to clinical scoring tools in predicting postoperative mortality in patients following cardiac surgery. Explanatory models show the potential to provide personalized risk profiles for individuals by accounting for the contribution of influencing factors. Additional prospective multicenter studies are warranted to confirm the clinical benefit of these machine learning-driven models.

Herein, a novel biosorbent originated from sugar beet pulp (SBP) was synthesized by microwave-assisted esterification with maleic anhydride (MA) and further decorated with ferric hydroxide. Characterization methods including FT-IR, SEM, XRD, Zeta potential, BET, TG and XPS were used to determine anticipative modification of SBP. The co-modified product of SBP (FMSBP) was applied for the cationic methylene blue (MB) dye removal and the optimization of experimental parameters such as biosorbent dosage, initial pH, contact time, initial MB concentration and temperature were investigated. Biosorption equilibrium followed the Langmuir isotherm model with a theoretical maximum biosorption capacity of 641.3 mg g−1 and the pseudo-second-order kinetic model was more suitable to describe kinetic data, while thermodynamic calculations indicated a spontaneous and exothermic biosorption process. Surface complexation and electrostatic interactions were involved in biosorption mechanisms, and the superior biosorption performance of FMSBP was achieved within 150 min at pH 8. Furthermore, FMSBP was demonstrated for the successful application in simulated real wastewater treatment, and the removal efficiency of MB remained above 70% after six desorption-resorption cycles, indicating a stable and promising biosorbent for decontamination of wastewater containing cationic dye.

A natural hydrogel film was prepared using carboxymethyl cellulose (CMC), cellulose nanocrystals (CNC), and hydroxypropyl β cyclodextrin (HP-β-CD) as reactants and citric acid as the cross-linking agent and used for the controlled release of neohesperidin-copper(II)(NH-Cu (II)). The hydrogel film was characterized by ATR-FTIR, XRD, TGA and DSC. The film showed controlled swelling behavior; the release behavior of NH-Cu(II) from the hydrogel film was also investigated in different solutions including distilled water, various salt solutions including 0.9% NaCl, and solutions having different pH values. Thiazolyl blue tetrazolium bromide assay and relative growth rates were adopted to evaluate the biocompatibility and cytotoxicity of the prepared hydrogel films. The results indicated that the expansion kinetics followed Fickian diffusion and Schott's second-order kinetics model. The hydrogel film exhibited enhanced mechanical properties and improved thermal stability at high temperatures due to the addition of CNC, with the amount of added CNC affecting the swelling ratio, salt sensitivity, and pH sensitivity of the hydrogel film in different solutions. Additionally, the CNC largely improved the loading and encapsulation efficiency of the hydrogel films, with the optimal CNC addition amount being 4% which yielded a loading amount of 753.75 mg/g and an accumulated release rate of 85.08%. The hydrogel film with proven cell compatibility and non-cytotoxicity can potentially be used as a drug delivery and controlled release material.

Advantame is a novel sweetener, and 3‐hydroxy‐4‐methoxy benzal acrolein is an important intermediate to synthesize the sweetener. The aim of this study was to evaluate a new low‐cost method to purify 3‐hydroxy‐4‐methoxy benzal acrolein, and the crude intermediate was used as raw material. The intermediate was purified using a low‐pressure column chromatography with a C18 column, using a methanol‐water (6:4, v/v) at a flow rate of 6.0 ml/min, and the loading amount of the crude intermediate in solution was 10.0 mg in total. A method for the analysis of 3‐hydroxy‐4‐methoxy benzal acrolein was established using high‐performance liquid chromatography (HPLC). This method was validated in terms of its linearity, repeatability, accuracy, detection limit, and quantitation limit. The calibration curves of 3‐hydroxy‐4‐methoxy benzal acrolein were linear (r > .999) over a wide concentration range of 0.005–0.08 mg/ml, by comparing the ratio of signal to noise, and the detection limit was 5.0 ng/ml and the quantification limit was 15.0 ng/ml. Good repeatability was obtained (RSD, In this study, a new low‐cost method for the preparation and purification of a sweetner intermediate named 3‐hydroxy‐4‐methoxy benzal acrolein was described. The purifying method and analysis method could be a reference to develop other sweetener intermediates.

An analysis method was developed for the separation and quantification of hesperidin, neohesperidin, neohesperidin dihydrochalcone and hesperetin by using HPLC-UV. Single factor experiments and Box-Behnken Designs were used to optimize separation of four flavonoids, in which a gradient elution method was adopted with 99% acetonitrile and 0.1% formic acid as mobile phases at a flow rate of 0.9 mL/min. A C18 column was used with a column temperature of 35 °C. LODs and LOQs were below 0.84 µg/mL and 2.84 µg/mL, respectively. Linearity with good correlation coefficients (r > 0.99, n = 5) was attained, recovery rate of four flavonoids ranged from 88% to 130%, the RSD indicating results precision for analyzing hesperidin, neohesperidin, neohesperidin dihydrochalcone and hesperetin ranged from 1.2% to 4.6%. Finally, the present method could be successfully applied to identify and quantify hesperidin, neohesperidin and hesperetin in Fructus Aurantii Immaturus and Pericarpium Citri Reticulatae.

Background: With the promotion of minimally invasive concepts and advances in total thoracoscopic valve surgery, total thoracoscopic aortic valve surgery has become a new option for patients with aortic valve lesions. However, due to its anatomical characteristics, poor surgical field exposure and limited operating space, only a few centers have performed further studies on this procedure. Methods: We evaluate the safety and advantages of total thoracoscopic aortic valve replacement compared to the upper mini-sternotomy AVR group and the conventional AVR group with important perioperative data as well as early postoperative outcomes. Results: All patients successfully underwent elective surgery, with no intraoperative conversion or death occurring. Patients in the total thoracoscopy group had significantly prolonged CPB and aortic clamping (AC) times compared to the other two groups. The average Postoperative chest drainage in the first 24 h of the total thoracoscopic group was significantly less than the other two groups. The mean VAS pain score in the total thoracoscopic group was significantly less than the other two groups. In addition, the total thoracoscopic group had a significantly decreased ICU stay as well as the total hospital stay. Although the length of mechanical ventilation between groups did not show statistically significant differences, mechanical ventilation in the total thoracoscopy group had a smaller relative number. Conclusions: Despite the need for improvement, total thoracoscopic aortic valve replacement is safe, and may improve clinical outcome

Objective: To evaluate the learning curve and safety of total thoracoscopic mitral valve repair (MVP). Background: Total thoracoscopic MVP is characterized by minimal trauma, minimal bleeding, and short postoperative recovery time. The learning curve of any new procedure needs to be evaluated for learning and replication. However, minimally invasive mitral valve technique is a wide-ranging concept, no further analysis of the outcomes and learning curve of total thoracoscopic mitral valve repair has been performed. Methods: One hundred and fifty consecutive patients who underwent minimally invasive MVP alone without concurrent surgery were evaluated. Using Cardiopulmonary bypass (CPB) time and Aortic clamping (AC) time as evaluation variables, we visualized the learning curve for total thoracoscopic MVP using Cumulative sum analysis. We also analyzed important postoperative variables such as postoperative drainage, duration of mechanical ventilation, ICU stay and postoperative hospital stay. Results: The slope of the fitted curve was negative after 75 procedures, and the learning curve could be crossed after the completion of the 75th procedure when AC and CPB time were used as evaluation variables. And as the number of surgical cases increased, CPB, AC, postoperative drainage, duration of mechanical ventilation, ICU stay and postoperative hospital stay all showed different degrees of decrease. The incidence of postoperative adverse events is similar to conventional mitral valve repair. Conclusions: Compared to conventional MVP, total thoracoscopic MVP provides the same satisfactory surgical results and stabilization can be achieved gradually after completion of the 75th procedure.

Objectives: The study sought to examine the prognostic impact of valvular surgery in patients with severe dilated left ventricle(DL) and assess morphological and functional changes of DL in the early period after operation. Methods: From January 2013 to December 2018, at a single center, 126 patients with severe dilated left ventricle (DL group) and 511 patients with 511 patients with normal sized left ventricle (NL group) underwent heart valve surgery. Retrospective review of the procedure and the postoperative clinical course, including echocardiography were analyzed in 6 to 12-month follow up. Results: Compared with NL group, DL group had significantly higher postoperative all-cause mortality (3.2% vs 1.4%) and complication rate, as well as longer duration of mechanical ventilation and vasoactive agents support. In DL group, 4 (3.2%) patients died in the early postoperative stage among which 2 (1.6%) patients died from multiple organ failure (MOF) secondary to severe low-output syndrome, 2 (1.6%) patients died from ventricular fibrillation. The DL group had longer time of mechanical ventilation and vasoactive agents support than NL group postoperatively. In DL group, the progressive regression of end-diastole diameter (LVEDD) was observed during the follow-up; whereas left ventricular ejection function (LVEF) and left ventricular fractional shortening (LVFS) showed a temporary decrease in early postoperative stage and then improved gradually. Conclusion: Heart valve surgery performed in an experienced center, along with sophisticated perioperative management, could bring satisfying early outcomes to patients with severe dilated left ventricle.

In this study, ovalbumin (OVA) formed a complex with neohesperidin (NH) via a pH-shifting method. The NH-OVA complex self-assembled into NH-OVA nano-particles, which were then characterized and whose binding mechanism was evaluated by using multi-spectroscopic, thermodynamics, and molecular docking simulation methods. Fluorescence intensity decreased after OVA was complexed with NH. The binding constant of the OVA-NH complex was in the order of 6.32 × 10

Antioxidant and antimicrobial chitosan (CS) films incorporated with different concentrations (0, 3, 6 and 9% w/w based on chitosan) of pomegranate peel powder (PPP) were prepared through a simple and low-cost process and characterized. The physicochemical property, antioxidant and antibacterial properties of the films were investigated. Results showed that incorporation with PPP increased the thickness, water solubility (WS), water vapor permeability (WVP), opacity and total phenolic content (TPC) of chitosan films, but decreased the moisture content (MC) and mechanical property. Fourier transform infrared (FTIR) spectroscopy indicated the formation of hydrogen bonds between chitosan and PPP. In addition, scanning electron microscopy (SEM) analysis presented that microstructural attributes of chitosan film changed by enriching with pomegranate peel. The films with concentrations of PPP at 6 and 9% presented great ultraviolet-visible light barrier properties. Moreover, the antioxidant ability of films with PPP was significantly increased compared to the chitosan film. The addition of PPP also promoted the antibacterial capacity of the control film. These results revealed that incorporation of PPP in chitosan film could fabricate an economical active film with antioxidant and antibacterial properties, and which had the potential for developing food-grade packaging material.

Nb/Ta-codoped TiO2 (NTTO)/Cu/NTTO (TCT) multilayers formed from two NTTO layers with a Cu interlayer have been deposited by magnetron sputtering on glass substrates for possible use as transparent conductive films. The variations in the growth, structure, and optical and electrical properties of the TCT samples were investigated as a function of the thickness of the Cu layer (dCu). The results show that the crystallinity of the top NTTO film is controlled by dCu. The critical thickness of the Cu layer for the formation of a continuous structure is about 11 nm, which is also the inflection point of the visible transmittance. As dCu was increased from 0 nm to 23 nm, the electrical resistivity of the TCT film decreased from 2.7 × 10−3 Ω cm to 5.6 × 10−5 Ω cm. The TCT multilayer with a 16-nm Cu interlayer showed a sheet resistance of 6.7 Ω/sq, an average visible transmittance of 80%, and an optimum figure of merit of 3.0 × 10−2 Ω−1.

Novel eco-friendly and green dimethyldiallylammonium chloride (DMDAAC) grafted chitosan/genipin/cellulose hydrogel beads (CCBG-g-PDMDAAC), were fabricated as selective adsorbents for anionic dyes. The physical and chemical structural changes of the prepared hydrogels were evaluated by FTIR, XRD, SEM and TG-DSC analysis. Results showed CCBG-g-PDMDAAC efficiently and selectively adsorb anionic dyes (Reactive Red 195-RR195 and Methyl orange-MO) from mixture of dye solutions. Endowed chitosan-based hydrogels the advantage of acid insolubility and good adsorption. RR195 and MO adsorption process were described better with pseudo-second-order kinetic model and Langmuir isotherm model with a maximum adsorption capacity of 1333.52 and 190.48 mg/g, respectively, indicating that monolayer chemisorption controlled the sorption process. Moreover, the hydrogels exhibited nice reusability and against S. aureus and E. coli. The hydrogels are promising for the potential application in wastewater treatment and antibacterial simultaneously.

A cellulose-based sodium alginate/iron hydroxide (C/SA/Fe) composite hydrogel was fabricated by using epichlorohydrin as cross-linking agent as an effective adsorbent for dye. The physicochemical structure of the C/SA/Fe hydrogel was characterized by SEM, FTIR, XRD and TG. The adsorption performance for the removal of methylene blue (MB) was investigated. In addition, the selective adsorption of cationic dye was also studied. The FTIR analysis revealed that the Fe(OH)3 colloidal particles were successfully combined in the cellulose/sodium alginate hydrogel. The modified hydrogel had better adsorption performance, and the maximum adsorption capacity of C/SA/Fe0.5 for MB was 105.93 mg/g according to the fitting results of adsorption isotherm. The kinetic study showed that the adsorption of MB onto C/SA/Fe was more consistent with the pseudo-second-order model, and was dominated by chemisorption mechanism such as ion exchange or electron sharing. The adsorption data fits well with the Langmuir model. Thermodynamics analysis showed that the MB adsorption by C/SA/Fe was exothermic, spontaneous, favorable and feasible. After five adsorption–desorption cycles, the adsorption capacity was almost unchanged. So, the C/SA/Fe hydrogel is a potential material in the field of the recovery of agricultural by-products or other bio-based cellulose, or environmental protection, etc.

In mid-2020, using next-generation sequencing (NGS) technology, we identified a recombinant cluster 2 avian orthoreovirus (ARV) variant named PHC-2020-0545, isolated from tendons of 33-day-old broilers with leg swelling in China. Complete genomic sequencing and analyses demonstrated that the isolate was genetically significantly distinct from known ARV strains in M1 and M3 genes and its σC coding gene had an extremely high variability, compared with the identified ARV strains grouped into other genotyping cluster. Further analysis showed that many base substitutions were silent and non-silent substitutions are most likely to occur in the first positions of codons. Multiple segmental recombination, intra-segmental recombination and accumulation of point mutations might contribute to the emergence of this isolate. The PHC-2020-0545 strain had a strong replication ability in 1-day-old broilers, and mainly affected the movement, digestion and metabolism of broilers. In addition, the infection route of the isolate is related to its pathogenicity to broilers. Therefore, combined with its unique genetic characteristics and potential origin, we determined that the PHC-2020-0545 field strain is a novel recombinant ARV strain, which has certain reference value for the preparation and evaluation of new vaccines.

Hydropericardium hepatitis syndrome (HHS) is a fatal disease caused by fowl adenovirus serotype 4 (FAdV-4). Avian viral arthritis is an infectious disease characterized by movement disorders caused by avian orthoreovirus (ARV). In the early 2019, our epidemiologic survey on poultry diseases in eight commercial broiler farms in China showed that FAdV-4 and ARV have a high coinfection rate, accounting for 63 % of all ARV-positive samples. We designed chicken embryo and animal models to investigate the synergistic pathogenicity of FAdV-4 and ARV. Weakness and inappetence were observed in all specific-pathogen-free (SPF) chickens of the experimental group. FAdV-4 and ARV coinfection caused severe embryonic body and hepatic hemorrhage in SPF chicken embryos. Compared with the singular ARV-infected group, joint swelling was more severe in all coinfected groups. Compared with single virus infection, the coinfection of the two viruses increased the mortality of SPF chicken embryos and chickens. FAdV-4 and ARV coinfection resulted in significantly severe macroscopic and microscopic lesions of the liver, spleen, and kidney of SPF chickens. The detection results of viral load in allantoic fluid, liver, and cloacal swabs indicated that ARV enhanced FAdV-4 replication in SPF chicken embryos and chickens. Cytokine detection showed a significant change in interleukin-1 (IL-1), IL-6, and interferon-α (IFN-α) levels in coinfected groups compared with those in the single-infected groups. Additionally, FAdV-4 and ARV coinfection caused severe damage to the SPF chicken's immune system. In summary, these findings provide insights into the pathology, prevention, and treatment of FAdV-4 and ARV coinfection.

The complexation of a flavonoid with metal ions usually can better the bioactivity or bioavailability of the flavonoid. A new method was designed and developed to synthesize a new neohesperidin-Cu(II) complex using ion-exchanging resin column. On the column, the integration of separation or desorption of neohesperidin on resins and the reaction of neohesperidin with Copper(II) was realized. Possible synthesis mechanism was discussed using UV-Vis, FT-IR, XRD, TGA and the Hard and Soft Acid and Base Principle. In addition, the inhibition of the complex on the tyrosinase activity was also studied. Results shows that Resin D296, as a macro-porous strong basic anion-exchange resin, can enrich neo-hesperidin effectively, and the saturated adsorption capacity is 2.38 mg per mL wet resins. During the integration method, the CuCl2 concentration should be 0.2 mol/L. Possible mechanism for the integration lies on three factors. One is the exchange between NH anions and Cl- ; the second is that neohesperidin as a soft base can form a stable complex with Cu2+ a borderline acid through the stoichiometric ratio of 2:1(neohesperidin:Cu2+ ) ; the third is that the “embedding effect” of neohesperidin on Cu2+ and the “concentrate effect of Cu2+ on neohesperidin, and the aforesaid two effects helps to better the neohesperidin solubility through the complexation process, since the glycosyl part is outside neohesperidin because of the “concentrate effect” of Cu2+ for hydrophobic aglycone part. The complex of neohesperidin-copper(II) can inhibit the tyrosinase activity，and our research findings can offer a reference to the value-added development of effective ingredients in plants.

Two novel polysaccharide fractions (HLP1-1 and HLP2-1) were purified from crude polysaccharides of Helvella leucopus by using DEAE-52 column (2.6cm×20cm) and Sephadex G-150 column (1.6×60cm). The characterization, antioxidant and anticancer activities of HLP1-1 and HLP2-1 were investigated. The GPC results showed that HLP1-1 and HLP2-1 had similar molecular weight (21,382Da and 23,063Da, respectively). Tertiary structure analyses indicated that HLP2-1 had triple-helical conformation, but HLP1-1 not. The monosaccharide compositions of HLP1-1 included rhamnose, glucosamine and mannose at a molar ratio of 11.8:1:78.6, and HLP2-1 included of rhamnose, glucosamine, glucose and mannose at a molar ratio of 4.2:1:18.1:27.3. Both HLP1-1 and HLP2-1 showed a certain antioxidant activity, and HLP2-1 showed stronger antioxidant activities than HLP1-1. Both HLP1-1 and HLP2-1 exhibited a relatively inhibition on HepG2.

The substrate/(200–900 nm) Al:ZnO (AZO)/15 nm Zn films were deposited on glass substrates at room temperature by magnetron sputtering, followed by a face-to-face annealing in vacuum. The effect of AZO thickness and the annealing treatment on the structure, morphology and electrical properties of the bilayer films was discussed. All the samples show a hexagonal wurtzite structure with (0 0 2) preferred orientation and the annealed samples have a uniform surface morphology and low surface roughness (∼1 nm). Compared with as-deposited films, annealed films present a significant increase in the carrier concentration, which can be attributed to the effective elimination of Zn-vacancy defects by successfully introducing Zn atoms into AZO layers. The lowest resistivity of 3.36 × 10−4 Ω cm with carrier concentration of 1.67 × 1021 cm−3 can be obtained. In addition, based on the results of above experiments, the Zn + AZO multilayer films with four different Zn diffusion models were fabricated. The average visible transmittance of the films is in the range of 79.1–85.2%. The substrate/AZO/Zn model has the optimum electrical performance, while the substrate/AZO/Zn/AZO model exhibits the highest optoelectronic figure of merit of 3.47 × 103 Ω−1 cm−1. Keywords: Aluminum doped zinc oxide thin films, Magnetron sputtering, Zinc diffusion, Optoelectronic properties

Chemical composition, anti-inflammatory activity, and cytotoxicity of essential oils obtained from the aerial parts of Trachydium roylei were investigated in this study. The chemical composition of T. roylei essential oil was analyzed using gas chromatography mass spectrometry. Fifty-nine components, representing 98.87% of the oils, were characterized. The oils were predominated by aromatic compounds and monoterpene hydrocarbons, and the main components were myristicin (25.35%), β-phellandrene (22.95%), elemicine (7.69%), isoelemicin (5.48%), and cedrol (5.26%). The anti-inflammatory activity of the oil in lipopolysaccharide-stimulated murine RAW 264.7 cells was evaluated. The oils downregulated the production of proinflammatory cytokines, including tumor necrosis factor-α, interleukin (IL)-1β, and IL-6, and significantly increased the anti-inflammatory cytokine IL-10 levels. Results indicated that the oils effectively inhibited the secretion of nitric oxide and prostaglandin E2 in lipopolysaccharide-stimulated macrophages. Western blot analyses were performed to determine whether the inhibitory effects of the oils on proinflammatory mediators (nitric oxide and prostaglandin E2) were related to the modulation of inducible nitric oxide synthase and cyclooxygenase-2 expression. These findings suggest that T. roylei essential oils exert an anti-inflammatory effect by regulating the expression of inflammatory cytokines.

A stepwise ethanol-precipitation (SEP) procedure was developed for the purification of sugar beet pectins (SBP) from a pectin-containing aqueous extract. Five fractions of different chemical and molecular characteristics were produced by stepwise elevating the alcohol concentration of the precipitation medium from 50% to 80% v/v. Comparison of chemical and macromolecular features between the obtained fractions indirectly suggested that the ability of pectin to solubilize in the ethanol-water binary mixture depended greatly on the polymer structure. Fractions rich in neutral sugars were precipitated at relatively high ethanol concentrations, probably due to the enhanced interactions generated between pectin side chains and solvent molecules. Furthermore, the obtained fractions displayed different surface activities. Results obtained in this work indicate that the SEP procedure is more selective with respect to pectin structural features and surface properties than the one-step ethanolic precipitation.

Sugar beet pectins (SBP) were precipitated from a purified extract in a 75% v/v ethanol solution at an initial extract pH (I-pH) ranging from 2.0 to 4.5. The effects of I-pH on pectin yield and pectin-cation interactions were studied. No simple correlation between pectin yield and I-pH was observed. The lowest pectin yield was obtained by precipitating the acidic pectin extract with ethanol at I-pH 4.5. Pectin yield increased to a maximum value as I-pH decreased from 4.5 to 3.0. These results indicated that decreased electrostatic repulsion between pectin chain segments enhanced pectin chain–chain interactions, thereby improving the precipitation effect. A decrease in pectin yield was observed as I-pH decreased below 3.0. The cation content of various samples was measured by high-performance cation-exchange chromatography in order to determine the content of SBP-bound cations during precipitation. Cation content and degree of cation binding were measured for pectins precipitated at I-pH 3.0, 2.5, and 2.0, and the results revealed that a decrease in pectin yield accompanied a decrease in cation–pectin interactions. These results suggest that the precipitation of SBP from an aqueous extract involves complex interactions between cations, solvent molecules, and pectin chain segments. The larger precipitation effect observed with divalent ions compared to monovalent ions may be due to enhanced inter-chain interactions between pectin molecules, probably via the formation of intermolecular bonds.