Prediction model establishment and validation for enteral nutrition aspiration during hospitalization in patients with acute pancreatitis

BACKGROUND Acute pancreatitis(AP)is a disease caused by abnormal activation of pancreatic enzymes and can lead to self-digestion of pancreatic tissues and dysfunction of other organs.Enteral nutrition plays a vital role in the treatment of AP because it can meet the nutritional needs of patients,promote the recovery of intestinal function,and maintain the barrier and immune functions of the intestine.However,the risk of aspiration during enteral nutrition is high;once aspiration occurs,it may cause serious complications,such as aspiration pneumonia,and suffocation,posing a threat to the patient’s life.This study aims to establish and validate a prediction model for enteral nutrition aspiration during hospitalization in patients with AP.AIM To establish and validate a predictive model for enteral nutrition aspiration during hospitalization in patients with AP.METHODS A retrospective review was conducted on 200 patients with AP admitted to Chengdu Shangjin Nanfu Hospital,West China Hospital of Sichuan University from January 2020 to February 2024.Clinical data were collected from the electronic medical record system.Patients were randomly divided into a validation group(n=40)and a modeling group(n=160)in a 1:4 ratio,matched with 200 patients from the same time period.The modeling group was further categorized into an aspiration group(n=25)and a non-aspiration group(n=175)based on the occurrence of enteral nutrition aspiration during hospitalization.Univariate and multivariate logistic regression analyses were performed to identify factors influencing enteral nutrition aspiration in patients with AP during hospitalization.A prediction model for enteral nutrition aspiration during hospitalization was constructed,and calibration curves were used for validation.Receiver operating characteristic curve analysis was conducted to evaluate the predictive value of the model.RESULTS There was no statistically significant difference in general data between the validation and modeling groups(P>0.05).The comparison of age,gender,body mass index,smoking history,hypertension history,and diabetes history showed no statistically significant difference between the two groups(P>0.05).However,patient position,consciousness status,nutritional risk,Acute Physiology and Chronic Health Evaluation(APACHE-II)score,and length of nasogastric tube placement showed statistically significant differences(P<0.05)between the two groups.Multivariate logistic regression analysis showed that patient position,consciousness status,nutritional risk,APACHE-II score,and length of nasogastric tube placement were independent factors influencing enteral nutrition aspiration in patients with AP during hospitalization(P<0.05).These factors were incorporated into the prediction model,which showed good consistency between the predicted and actual risks,as indicated by calibration curves with slopes close to 1 in the training and validation sets.Receiver operating characteristic analysis revealed an area under the curve(AUC)of 0.926(95%CI:0.8889-0.9675)in the training set.The optimal cutoff value is 0.73,with a sensitivity of 88.4 and specificity of 85.2.In the validation set,the AUC of the model for predicting enteral nutrition aspiration in patients with AP patients during hospitalization was 0.902,with a standard error of 0.040(95%CI:0.8284-0.9858),and the best cutoff value was 0.73,with a sensitivity of 91.9 and specificity of 81.8.CONCLUSION A prediction model for enteral nutrition aspiration during hospitalization in patients with AP was established and demonstrated high predictive value.Further clinical application of the model is warranted.

Clinical characteristics of drug-induced liver injury and primary biliary cirrhosis

AIM To summarize and compare the clinical characteristics of drug-induced liver injury(DILI) and primary biliary cirrhosis(PBC).METHODS A total of 124 patients with DILI and 116 patients with PBC treated at Shengjing Hospital Affiliated to China Medical University from 2005 to 2013 were included. Demographic data(sex and age),biochemical indexes(total protein,albumin,alanine aminotransferase,aspartate aminotransferase,total bilirubin,direct bilirubin,indirect bilirubin,alkaline phosphatase,and gamma glutamyltransferase),immunological indexes [immunoglobulin(Ig) A,Ig G,Ig M,antinuclear antibody,anti-smooth muscle antibody,anti-mitochondrial antibody,and anti-mitochondrial antibodies] and pathological findings were compared in PBC patients,untyped DILI patients and patients with different types of DILI(hepatocellular type,cholestatic type and mixed type). RESULTS There were significant differences in age and gender distribution between DILI patients and PBC patients. Biochemical indexes(except ALB),immunological indexes,positive rates of autoantibodies(except SMA),and number of cases of patients with different ANA titers(except the group at a titer of 1:10000)significantly differed between DILI patients and PBC patients. Biochemical indexes,immunological indexes,and positive rate of autoantibodies were not quite similar in different types of DILI. PBC was histologically characterized mainly by edematous degeneration of hepatocytes(n = 30),inflammatory cell infiltration around bile ducts(n = 29),and atypical hyperplasia of small bile ducts(n = 28). DILI manifested mainly as fatty degeneration of hepatocytes(n = 15) and spotty necrosis or loss of hepatocytes(n = 14).CONCLUSION Although DILI and PBC share some similar laboratory tests(biochemical and immunological indexes) and pathological findings,they also show some distinct characteristics,which are helpful to the differential diagnosis of the two diseases.

Analysis of factors potentially predicting prognosis of colorectal cancer

BACKGROUND Accurate assessment of the prognosis after colorectal cancer surgery is of great significance in patients with colorectal cancer.However,there is no systematic analysis of factors affecting the prognosis of colorectal cancer currently.AIM To systematically analyze the influence of clinical data and serological and histological indicators on the prognosis of patients with colorectal cancer,and to explore the indicators that can accurately assess the prognosis of patients with colorectal cancer.METHODS A total of 374 patients with colorectal cancer were enrolled.The clinical data,tumor-node-metastasis(TNM)stage,and Dukes stage were recorded.All patients received examinations including carcinoembryonic antigen(CEA),carbohydrate antigen 199,C-reactive protein,albumin,D-dimer,and fibrinogen as well as routine blood tests one week before surgery.The tumor location,size,depth of invasion,lymph node metastasis,and distant metastasis were recorded during surgery.The pathological tissue typing and expression of proliferating cell nuclear antigen(PCNA)and p53 were observed.All patients were followed for 3 years,and patients with endpoint events were defined as a poor prognosis group,and the remaining patients were defined as a good prognosis group.The differences in clinical data,serology,and histology were analyzed between the two groups.Multivariate COX regression was used to analyze the independent influencing factors for the prognosis of colorectal cancer.The receiver operating characteristic curve was used to evaluate the predictive value of each of the independent influencing factors and their combination for the prognosis of colorectal cancer.RESULTS The follow-up outcomes showed that 81 patients were in the good prognosis group and 274 patients in the poor prognosis group.The TNM stage,PCNA,Glasgow prognostic score(GPS),neutrophil-lymphocyte ratio(NLR),C-reactive protein/albumin ratio(CAR),D-dimer,and CEA were independent influencing factors for the prognosis of colorectal cancer(P=0.000).NLR had the highest predictive power for colorectal cancer prognosis[area under the receiver operating characteristic curve(AUC)=0.925],followed by D-dimer(AUC=0.879)and GPS(AUC=0.872).The accuracy of the combination of all indicators in predicting the prognosis of colorectal cancer was the highest(AUC=0.973),which was significantly higher than that of any of the indicators alone(P<0.05).The sensitivity and specificity of the combination were 92.59%and 90.51%,respectively.CONCLUSION The independent influence factors for the prognosis of colorectal cancer include TNM stage,PCNA,GPS,NLR,CAR,D-dimer,and CEA.The combined assessment of the independent factors is the most accurate predictor of the prognosis after colorectal cancer surgery.

Influences of Network Delay on Quality of Experience for Soft Objects in Networked Real-Time Game with Haptic Sense

In this paper, we investigate the influences of network delay on QoE (Quality of Experience) such as the operability of haptic interface device and the fairness between players for soft objects in a networked real-time game subjectively and objectively. We handle a networked balloon bursting game in which two players burst balloons (i.e., soft objects) in a 3D virtual space by using haptic interface devices, and the players compete for the number of burst balloons. As a result, we find that the operability depends on the network delay from the local terminal to the other terminal, and the fairness is mainly dependent on the difference in network delay between the players’ terminals. We confirm that there exists a trade-off relationship between the operability and the fairness. We also see that the contribution of the fairness is larger than that of the operability to the comprehensive quality (i.e., the weighted sum of the operability and fairness). Assessment results further show that the output timing of terminals should be adjusted to the terminal which has the latest output timing to maintain the fairness when the difference in network delay between the terminals is large. In this way, the comprehensive quality at each terminal can be maintained as high as possible.

Steady-State and Time-Resolved Fluorescence Studies of Anthrylacrylic Ester

The photophysical properties of Anthrylacrylic ester were investigated in various solvents using steady-state and time-resolved fluorescence techniques. The dual fluorescence was observed in various solvents of different polarity functions. The emission bands observed are around 400 nm (band I) and 480 nm (band II) for 350 nm and 390 nm excitation at low concentrations (10–5 mol·dm–3) but at higher concentrations (10–3 mol·dm–3) only the emission (band II) at 480 nm alone was observed. The emission band observed around 400 nm shifts from 390 nm to 420 nm (shift 30 nm) when the excitation wavelength was varied from 300 nm to 380 nm and the emission band at 480 nm shifts from 430 nm to 510 nm (shift 80 nm) for the change of excitation wavelength from 380 nm to 400 nm. However, both emissions were observed for 380 nm excitation at lower concentrations. Solvatochromic shifts of electronic absorption and fluorescence emissions (band I & II) as a function of polarity functions were analyzed and the changes in dipole moment of the molecule was estimated (Δμ = 3.36 D & 5.98 D). Fluorescence decays monitored over each emission maxima showed bi-exponential behavior, and yielded two lifetime components respectively in the range 0.97 - 7.1 ns (at λem = 400 nm) and 0.34 - 7.23 ns (at λem = 480 nm). Based on the steady-state and time-resolved emission measurements emission band I (400 nm) and emission band II (480 nm) are respectively assigned as due to locally excited state (Trans-forms) and due to isomers (Cis-form).

Head-to-head comparison of 7 high-sensitive human papillomavirus nucleic acid detection technologies with the SPF10 LiPA-25 system

Background:The SPF10 LiPA-25 system for human papillomavirus(HPV)detection with high analytical perfor-mance is widely used in HPV vaccine clinical trials.To develop and evaluate more valent HPV vaccines,other comparable methods with simpler operations are needed.Methods:The performance of the LiPA-25 against that of other 7 assays,including 4 systems based on reverse hybridization(Bohui-24,Yaneng-23,Tellgen-27,and Hybribio-16)and 3 real-time polymerase chain reaction(PCR)assays(Hybribio-23,Bioperfectus-21,and Sansure-26),was evaluated in selected 1726 cervical swab and 56 biopsy samples.A total of 15 HPV genotypes(HPV 6,11,16,18,31,33,35,39,45,51,52,56,58,59,and 66)were considered for comparison for each HPV type.Results:Among the swab samples,compared to LiPA-25,compatible genotypes were observed in 94.1%of samples for Hybribio-23,92.8%for Yaneng-23,92.6%for Bioperfectus-21,92.4%for Hybribio-16,91.3%for Sansure-26,89.7%for Bohui-24,and 88.0%for Tellgen-27.The highest overall agreement of the 15 HPV genotypes combined was noted for Hybribio-23(κ=0.879,McNemar’s test:P=0.136),followed closely by Hybribio-16(κ=0.877,P<0.001),Yaneng-23(κ=0.871,P<0.001),Bioperfectus-21(κ=0.848,P<0.001),Bohui-24(κ=0.847,P<0.001),Tellgen-27(κ=0.831,P<0.001),and Sansure-26(κ=0.826,P<0.001).Additionally,these systems were also highly consistent with LiPA-25 for biopsy specimens(all,κ>0.897).Conclusions:The levels of agreement for the detection of 15 HPV types between other 7 assays and LiPA-25 were all good,and Hybribio-23 was most comparable to LiPA-25.The testing operation of HPV genotyping should also be considered for vaccine and epidemiological studies.

Navigating the future:Embracing resilience and interoperability in the industrial internet

In the midst of the fourth industrial revolution,the convergence of the digital,physical,and biological realms is propelling industrial innovation to new heights.At the heart of this transformative era lies the Industrial Internet,a pivotal technology reshaping our industries.This powerful force establishes an all-encompassing network[1-2].

The impact of sample processing on the rapid antigen detection test for SARS-CoV-2: Virus inactivation, VTM selection, and sample preservation

Many factors have been identified as having the ability to affect the sensitivity of rapid antigen detection(RAD)tests for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).This study aimed to identify the impact of sample processing on the sensitivity of the RAD tests.We explored the effect of different inactivation methods,viral transport media(VTM)solutions,and sample preservation on the sensitivity of four RAD kits based on two SARS-CoV-2 strains.Compared with non-inactivation,heat inactivation significantly impacted the sensitivity of most RAD kits;however,β-propiolactone inactivation only had a minor effect.Some of the VTM solutions(VTM2,MANTACC)had a significant influence on the sensitivity of the RAD kits,especially for low viral-loads samples.The detection value of RAD kits was slightly decreased,while most of them were still in the detection range with the extension of preservation time and the increase of freeze–thaw cycles.Our results showed that selecting the appropriate inactivation methods and VTM solutions is necessary during reagent development,performance evaluation,and clinical application。

Evaluation of factors contributing to variability of qualitative and quantitative proficiency testing for SARS-CoV-2 nucleic acid detection

The pandemic caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has led to unprecedented social and economic disruption.Many nucleic acid testing(NAT)laboratories in China have been established to control the epidemic better.This proficiency testing(PT)aims to evaluate the participants’performance in qualitative and quantitative SARS-CoV-2 NAT and to explore the factors that contribute to differences in detection capabilities.Two different concentrations of RNA samples(A,B)were used for quantitative PT.Pseudovirus samples D,E(different concentrations)and negative sample(F)were used for qualitative PT.50 data sets were reported for qualitative PT,of which 74.00%were entirely correct for all samples.Fortytwo laboratories participated in the quantitative PT.37 submitted all gene results,of which only 56.76%were satisfactory.For qualitative detection,it is suggested that laboratories should strengthen personnel training,select qualified detection kits,and reduce cross-contamination to improve detection accuracy.For quantitative detection,the results of the reverse transcription digital PCR(RT-dPCR)method were more comparable and reliable than those of reverse transcription quantitative PCR(RT-qPCR).The copy number concentration of ORF1ab and N in samples A and B scattered in 85,223,50,and 106 folds,respectively.The differences in the quantitative result of RT-qPCR was mainly caused by the non-standard use of reference materials and the lack of personnel operating skills.Comparing the satisfaction of participants participating in both quantitative and qualitative proficiency testing,95.65%of the laboratories with satisfactory quantitative results also judged the qualitative results correctly,while 85.71%of the laboratories with unsatisfactory quantitative results were also unsatisfied with their qualitative judgments.Therefore,the quantitative ability is the basis of qualitative judgment.Overall,participants from hospitals reported more satisfactory results than those from enterprises and universities.Therefore,surveillance,daily qualitiy control and standardized operating procedures should be strengthened to improve the capability of SARS-CoV-2 NAT.

Establishment and application of national reference panels for SARS-CoV-2 antigen detection kit

To develop a national reference panel for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)antigen detection kit and establish a quality standard.The cultures of SARS-CoV-2 and other pathogens were collected to establish a national reference panel for SARS-CoV-2 antigen detection.The stability and homogeneity of the reference panel were evaluated.Based on World Health Organization(WHO)guidance and nucleic acid quantitative results,a quality standard reference panel was established.Currently,three generations of SARS-CoV-2 antigen national reference materials with batch numbers 370095–202001,370095–202202,and 370095–202203 have been successfully established.These national reference panels comprised 8 positive samples,20 negative samples,1 repetitive sample,and 1 lower detection limit sample.The stability and homogeneity of the reference panel meet the requirements.The quality standards are as follows:the positive and negative coincidence rates are 8/8 and 20/20,respectively.The 10 test results of the medium and low-concentration repetitive reference materials should be positive,and the color rendering should be uniform(or the coefficient of variance should not be higher than 20.0%).The lower detection limit should be at least 5×105 U/mL(equivalent to copies/mL),and higher concentrations above the lower detection limit must be positive.A national reference panel for the SARS-CoV-2 antigen detection kit has been established.As the standard of SARS-CoV-2 antigen reagents,the reference panel has played a crucial role in the pre-marketing quality evaluation and post-marketing quality supervision in China.