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Preoperative nutritional status plays an important role in predicting postoperative outcomes. Prognostic Nutritional Index (PNI) and Controlling Nutritional Status (CONUT) are good tools to assess patients’ nutritional status. They have been used in predicting outcomes in various malignancies, but few studies have focused on pancreatic adenocarcinoma (PDAC) patients. Totally, 306 PDAC patients were enrolled. The propensity score matching (PSM) method was introduced to eliminate the baseline inequivalence. Patients with different PNI (or CONUT) scores showed inequivalence baseline characteristics, and patients with compromised nutritional status were related with a more advanced tumour stage. After PSM, the baseline characteristics were well balanced. Both low PNI (≤45) and high CONUT (≥3) were independent risk factors for poor overall survival (P < 0·05), and the result remained the same after PSM. Survival analysis demonstrated both patients with low PNI and high CONUT score were associated with poorer survival, and the result remained the same after PSM. The results of AUC indicated that CONUT might have a higher sensitivity and specificity in predicting complications and survival. Preoperative low PNI (≤45) and high CONUT (≥3) scores might be reliable predictors of prognosis and surgical complications in PDAC patients. Compared with PNI, CONUT might be more effective.
Chinese sturgeon (Acipenser sinensis) is an endangered species, listed as a grade I protected animal in China. The females rarely successfully develop their gonads from stage II to III in captivity, which handicaps the propagation of cultured Chinese sturgeon. The present study aimed to understand the effects of dietary lipid level on the ovarian development and the related regulation mechanism in female Chinese sturgeon. A 24-month feeding trial was conducted with 10-year-old Chinese sturgeons with ovaries at the developmental stage II, with three experimental diets containing 10, 14 and 18 % lipids. Ovary, muscle and serum samples were collected at four time points (6, 12, 18 and 24 months) for further analyses. Serum metabolomics and ovary transcriptomics analyses were conducted at 18 months. Results showed that only the 18 % lipid diet promoted ovary development to stage IV. Oocytes at stage II in this group also exhibited higher diameter and more lipid droplets. Serum TAG content in the 18 % group was significantly higher than in 10 and 14 % groups (both at 12 and 18 months). Oestradiol content in the 14 % group was significantly higher than in 10 and 18 % groups, except at 24 months. Metabolomic and transcriptomic results indirectly indicated that 14 % of dietary lipids benefited steroid hormone synthesis, while 18 % lipid facilitated arachidonic acid metabolism, cholesterol biosynthesis and vitellogenesis, although serum cholesterol content did not vary with dietary lipid level. In conclusion, 18 % dietary lipid is the optimal level for improving gonad development of female Chinese sturgeon.
To assess the effectiveness of radiofrequency catheter ablation for lone atrial fibrillation in young adults.
This single-centre, retrospective, observational study enrolled 75 consecutive patients (86.7% men) under 35 (median, 30) years old with lone atrial fibrillation (68% paroxysmal, 26.7% persistent, and 5.3% long-standing persistent) without other cardiopulmonary diseases who underwent catheter ablation between April 2009 and May 2017. Procedural endpoints were circumferential pulmonary vein ablation for atrial fibrillation with pulmonary vein trigger, and target ablation or bidirectional block of lines and disappearance of complex fractionated atrial electrograms for atrial fibrillation with clear and unclear non-pulmonary vein triggers, respectively.
Main study outcome was rate of survival free from atrial tachyarrhythmia recurrence, which at median 61 (range, 5–102) months follow-up was 62.7% (64.7 and 58.3% for paroxysmal and non-paroxysmal atrial fibrillation, respectively) after single ablation, and 69.3% (68.6 and 70.8% for paroxysmal and non-paroxysmal atrial fibrillation, respectively) after mean 1.2 ablations (two and three ablations in 11 and 2 patients, respectively). In multivariate analysis, non-pulmonary vein trigger was a significant independent predictor of recurrent atrial tachyarrhythmia (OR, 10.60 [95%CI, 2.25–49.96]; p = 0.003). There were no major periprocedural adverse events.
In patients under 35 years old with lone atrial fibrillation, radiofrequency catheter ablation appeared effective particularly for atrial fibrillation with pulmonary vein trigger and regardless of left atrial size or atrial fibrillation duration or type. Atrial tachyarrhythmia recurrence after multiple ablations warrants further study.
In this work, a novel shape-stabilized phase change material, composed of n-octadecane, expanded graphite (EG), and sodium chloride (NaCl), was prepared by a convenient method. In the composite, EG was used as the matrix material and NaCl served as the nucleating agent. Effects of the additional amount of NaCl on the thermal properties of the composite were investigated by DSC and TG. The melting and crystallization enthalpies of the composite are −160.23 J/g and 162.80 J/g, respectively; the supercooling degree of the composite decreased to 3.77 °C when compared to 7.58 °C of the pure n-octadecane. Furthermore, the thermal cycling performances became better, and the thermal decomposition temperature improved to 150 °C. The composite exhibited high latent heat, low supercooling degree, good thermal cycling performance, and enhanced thermal stability, making it a potential material for the thermal energy storage application in the field of thermal regulation.
Novel microencapsulated n-octadecane with natural silk fibroin (SF) shell attached with silver nanoparticles (AgNPs) on its surface was synthesized in oil-in-water emulsion via a self-assembly method. No additional reductant was used in the in situ preparation of AgNPs due to the inherent reduction property of tyrosine (Tyr) residues in SF. The microstructures and particle sizes of the resultant microcapsules were investigated by using a scanning electron microscope (SEM) and a laser scattering particle size distribution analyzer. The resulting microcapsules exhibited a regular spherical morphology with a 4–5 μm narrow diameter distribution range. And the AgNPs attached to the surface exhibited an even distribution. According to the analytical results of DSC, TGA, and infrared system, the SF-AgNPs microcapsule presents enhanced thermal stability and obvious thermal regulation properties. In addition, it was found that the SF-AgNP microcapsule also exhibited a good antibacterial activity against both Gram-positive bacteria (Staphylococcus aureus), and Gram-negative bacteria (Escherichia coli). The SF-AgNPs microcapsule synthesized in this study could be a potential candidate for thermal regulation and healthcare applications.
To revise an abbreviated version of the Silhouettes subtest of the Visual Object and Space Perception (VOSP) battery in order to recognize mild cognitive impairment (MCI) and determine the optimal cutoffs to differentiate among cognitively normal controls (NC), MCI, and Alzheimer’s Disease (AD) in the Chinese elderly.
A cross-sectional validation study.
Huashan Hospital, Shanghai, China.
A total of 591 participants: Individuals with MCI (n = 211), AD (n = 139) and NC (n = 241) were recruited from the Memory Clinic, Huashan Hospital, Shanghai, China.
Baseline neuropsychological battery (including VOSP) scores were collected from firsthand data. An abbreviated version of silhouettes test (Silhouettes-A) was revised from the original English version more suitable for the elderly, including eight silhouettes of animals and seven silhouettes of inanimate objects, with a score ranging from 0 to 15.
Silhouettes-A was an effective test to screen MCI in the Chinese elderly with good sensitivity and specificity, similar to the Montreal cognitive assessment and superior to other single tests reflecting language, spatial, or executive function. However, it had no advantage in distinguishing MCI from AD. The corresponding optimal cutoff scores of Silhouettes-A were 10 for screening MCI and 8 for AD.
Silhouettes-A is a quick, simple, sensitive, and dependable cognitive test to distinguish among NC, MCI, and AD patients.
Ti/Al/Mg/Al/Ti laminates were fabricated by hot rolling at 450 °C with various rolling reductions, and the relationship between the mechanical properties and microstructures was investigated in detail. Both Al–Mg and Ti–Al interfaces are well bonded without pore, crack, and intermetallics. Mg layer of 50% rolling reduction has the most dynamic recrystallized (DRXed) grains around the deformation bands, and tensile twins appear in Mg layer when the rolling reduction increases to 60%. Large numbers of twins are formed to absorb the further strain as reduction increases. Ti layer shows equiaxed grains, which are not sensitive to thickness strain. Mg layers of laminates with various rolling reductions all exhibit typical (0002) basal texture. Fifty-percent rolling reduction has the largest ultimate tensile strength of 337.8 MPa, which is mainly owing to grain refinement caused by the extensive DRX. The differences of elongation among the three samples with different rolling reductions are small.
Solid-state batteries are promising candidates for energy storage due to their potential advantages in safety, working temperature range, and energy density compared to traditional liquid-electrolyte-based batteries. Rational battery architecture design and a scalable fabrication approach are critical to realize solid-state batteries. In this article, we present the architecture, fabrication procedure, and related challenges of sulfide and oxide electrolyte-based solid-state batteries. Approaches toward intimate solid−solid contact, thin solid-electrolyte fabrication, and scale-up production are discussed. Finally, we discuss the future research directions of solid-state batteries.
Dilated Cardiomyopathy is a serious heart disorder that may induce sudden cardiac death and heart failure. Significant progress has been made in understanding the molecular basis of dilated cardiomyopathy. In previous studies, mutations in more than fifty genes have been identified in dilated cardiomyopathy patients. The purpose of this study was to detect the genetic lesion in a family from the central south of China affected by severe dilated cardiomyopathy.
Whole-exome sequencing combined with cardiomyopathy-related genes list were used to analyse the mutations of the proband. Co-segregation analysis was performed by Sanger sequencing.
Results and conclusions
Two novel heterozygous mutations – Myosin Binding Protein C: p.L1014RfsX6 and Titin: p.R9793X – were identified in the proband. The deletion mutation c.3041delT/p.L1014RfsX6 caused a premature stop codon at position 1020 in exon 28 of the Myosin Binding Protein C. The nonsense mutation, c.29377 C>T/ p. R9793X, of Titin was located in the highly evolutionarily conserved domain, resulting in truncation of the Titin protein as well. Co-segregation analysis further revealed that the Myosin Binding Protein C mutation came from his mother and the Titin mutation came from his father. Both mutations are reported in dilated cardiomyopathy patients for the first time. Our study not only provides a unique example of the genes and molecular mechanisms involved in dilated cardiomyopathy but also expands the spectrum of Myosin Binding Protein C and Titin mutations and contributes to the genetic diagnosis and counselling of dilated cardiomyopathy patients.
Propofol is a intravenous anaesthetic most commonly used in ultrasound oocyte retrieval. We studied if the use of propofol had an effect on mouse oocyte maturation, pregnancy, childbirth and progeny and investigated the correlation between propofol side effects and reproductive performance in mice. There was no statistical difference in mating, pregnancy, childbirth, litter size, the number of stillbirths and survival between each group (P>0.05). Propofol also had no effect on polar body extrusion in oocyte maturation as well as on pronucleus formation and, subsequently, early embryo development (P>0.05). An increased concentration of propofol had no effect on this result, although propofol at more than 0.01 mg/ml reduced polar body extrusion. Different concentrations of propofol had no effect on oocyte culture in vitro, pronucleus formation and early embryo development.
SCN5A encodes sodium-channel α-subunit Nav1.5. The mutations of SCN5A can lead to hereditary cardiac arrhythmias such as the long-QT syndrome type 3 and Brugada syndrome. Here we sought to identify novel mutations in a family with arrhythmia.
Genomic DNA was isolated from blood of the proband, who was diagnosed with atrial flutter. Illumina Hiseq 2000 whole-exome sequencing was performed and an arrhythmia-related gene-filtering strategy was used to analyse the pathogenic genes. Sanger sequencing was applied to verify the mutation co-segregated in the family.
Results and conclusions
A novel missense mutation in SCN5A (C335R) was identified, and this mutation co-segregated within the affected family members. This missense mutation was predicted to result in amplitude reduction in peak Na+ current, further leading to channel protein dysfunction. Our study expands the spectrum of SCN5A mutations and contributes to genetic counselling of families with arrhythmia.
There is no consensus or theoretical explanation regarding the optimal location for the fenestration during the Fontan operation. We investigated the impact of the location of the fenestration on Fontan haemodynamics using a three-dimensional Fontan model in various physiological conditions.
A three-dimensional Fontan model was constructed on the basis of CT images, and a 4-mm-diameter fenestration was located between the extracardiac Fontan conduit and the right atrium at three positions: superior, middle, and inferior part of the conduit. Haemodynamics in the Fontan route were analysed using a three-dimensional computational fluid dynamic model in realistic physiological conditions, which were predicted using a lumped parameter model of the cardiovascular system. The respiratory effect of the caval flow was taken into account. The flow rate through the fenestration, the effect of lowering the central venous pressure, and wall shear stress in the Fontan circuit were evaluated under central venous pressures of 10, 15, and 20 mmHg. The pulse power index and pulsatile energy loss index were calculated as energy loss indices.
Under all central venous pressures, the middle-part fenestration demonstrated the most significant effect on enhancing the flow rate through the fenestration while lowering the central venous pressure. The middle-part fenestration produced the highest time-averaged wall shear stress, pressure pulse index, and pulsatile energy loss index.
Despite slightly elevated energy loss, the middle-part fenestration most significantly increased cardiac output and lowered central venous pressure under respiration in the Fontan circulation.
Functionalization is critical for improving mechanical properties of carbon nanotubes (CNTs)/polymer nanocomposites. A fundamental understanding of the role of the CNT/polymer interface and bonding structure is key to improving functionalization procedures for higher mechanical performance. In this study, we investigated the effects of chemical functionalization on the nanocomposite interface at atomic resolution to provide direct and quantifiable information of the interactions and interface formation between CNT surfaces and adjacent resin molecules. We observed and compared electronic structures and their changes at the interfaces of nonfunctionalized and functionalized CNT/polymer nanocomposite samples via scanning transmission electron microscopy and electron energy-loss spectroscopy (EELS) spectrum imaging techniques. The results show that the state of sp2 bonding and its distribution at the CNT/resin interface can be clearly visualized through EELS mapping. We found that the functionalized CNT/polymer samples exhibited a lower fraction of sp2 bonding and a lower π*/σ* ratio compared with the nonfunctionalized cases. A good correlation between near-edge fine structures and low-loss plasmon energies was observed.
Results of the relationships between dietary whole-grain consumption and the risk of all-cause, CVD and cancer-specific mortality are mixed. We summarised the evidence based on a meta-analysis of prospective cohort studies. Pertinent studies were identified by searching articles in the MEDLINE and EMBASE databases up to 20 January 2016 and by reviewing the reference lists of the retrieved articles. Random-effects models were used to calculate summary relative risks (SRR) and 95 % CI. In all, eleven prospective studies (ten publications) were included in the meta-analysis. There were a total of 816 599 subjects and 89 251 cases of all-cause mortality. On the basis of the highest v. the lowest categories of intake, whole grains may be associated with a lower risk of mortality from all causes (SRR 0·87; 95 % CI 0·84, 0·90), CVD (SRR 0·81; 95 % CI 0·75, 0·89) and all cancers (SRR 0·89; 95 % CI 0·82, 0·96). For each 3 servings/d increase in whole-grain intake, there was a 19 % reduction in the risk of all-cause mortality (SRR 0·81; 95 % CI 0·76, 0·85), a 26 % reduction in CVD mortality (SRR 0·74; 95 % CI 0·66, 0·83) and a 9 % reduction in cancer mortality (SRR 0·91; 95 % CI 0·84, 0·98). The current meta-analysis provides some evidence that high intake of whole grains was inversely associated with the risk of all-cause, CVD and cancer-specific mortality. Further well-designed studies, including clinical trials and in different populations, are required to confirm our findings.
In light of government investment over the past decade, we explored the capacity for disaster response in Heilongjiang Province, identifying the factors that affect response capacity.
We surveyed 1257 medical staff in 65 secondary and tertiary hospitals in Heilongjiang province to explore their perceptions of disaster management capacity using a cross-sectional multistage, stratified cluster sampling method.
All tertiary hospitals (100%) and most secondary hospitals (93%) have documented disaster management plans that are regularly reviewed. In secondary hospitals, drills were less prevalent (76.7%) but the occurrence of simulated training exercises was closer to tertiary hospitals (86.0%). We noted that 95.4% of all hospitals have leadership groups responsible for disaster preparedness capacity building, but only 10.8% have a stockpiled network of reserve supplies.
Although response capacity has improved in Heilongjiang Province, vulnerabilities remain. We recommend that priorities should be targeted at preparedness capacity building, in terms of reliable and relevant operational response plans, the expansion of existing response mechanisms to oversee local education and scenario training, and to ensure there is sufficient access to protective equipment and materials, either held in reserve, or alternatively by activating resilient supply chain mechanisms. (Disaster Med Public Health Preparedness. 2018;12:176–183)