Impact of perioperative transfusion in patients undergoing resection of colorectal cancer liver metastases: A population-based study

BACKGROUND Perioperative allogeneic blood transfusion is associated with poorer outcomes.AIM To identify the factors that were associated with perioperative transfusion and to examine the impact of perioperative transfusion in patients undergoing resection of colorectal cancer(CRC)liver metastases.METHODS The United States National Inpatient Sample(NIS)database was searched for patients with CRC who received surgery for liver metastasis.Linear and logistic regression analyses were performed.RESULTS A total of 2018 patients were included,and 480 had a perioperative transfusion.Emergency admission(adjusted odds ratio[aOR]=1.42;95%CI:1.07-1.87),hepatic lobectomy(aOR=1.76;95%CI:1.42-2.19),and chronic anemia(aOR=2.62;95%CI:2.04-3.35)were associated with increased chances of receiving a transfusion,but receiving surgery at a teaching hospital(aOR=0.75;95%CI:0.58-0.98)was associated with a decreased chance of receiving a transfusion.Receiving a perioperative transfusion was significantly associated with increased in-hospital mortality(aOR=3.38;95%CI:1.57-7.25),and increased overall postoperative complications(aOR=1.67;95%CI:1.31-2.13),as well as longer length of hospital stay CONCLUSION Patients with an emergency admission,hepatic lobectomy,chronic anemia,and who have surgery at a non-teaching hospital are more likely to receive a perioperative transfusion.Patients with CRC undergoing surgery for hepatic metastases who receive a perioperative transfusion are at a higher risk of inhospital mortality,postoperative complications,and longer length of hospital stay.

Control of fibrosis and hypertrophic scar formation via glycolysis regulation with IR780

Background:Hypertrophic scars(HS)represent one of the most common clinical challenges due to unsatisfactory therapeutic results.HS formation is associated with the abnormal activation of fibroblasts and their excessive fibrotic behavior.Glycolysis dysregulation has been shown to participate in the incidence and progression of various fibrotic diseases and shows potential as a means of controlling HS formation.This work aimed to discuss the impact of augmented glycolysis on HS and to propose a method for controlling HS formation through glycolysis regulation.Methods:Here,augmented glycolysis was confirmed together with enhanced fibrotic activity in both HS fibroblasts(HFs)and HS tissues,and the suppression of glycolysis also attenuated fibroblast activation.We also introduced IR780,a heptamethine cyanine dye,to regulate glycolysis for the control of HS formation.Results:In vitro,cell studies indicated that IR780 significantly down-regulated glycolysis and suppressed the fibrotic activity of HFs.In vivo,the intralesional injection of IR780 into rabbit HS models led to the downregulation of glycolysis and the control of HS formation.Furthermore,IR780 accumulated preferentially in activated fibroblasts in both in vitro and in vivo studies,and thus specifically downregulated glycolysis and efficiently controlled fibrosis by targeting activated fibroblasts.Conclusions:This work identified a strategy for controlling fibrosis and HS formation from the perspective of glycolysis regulation with IR780 targeting of activated fibroblasts.

Defect tolerance in chalcogenide perovskite photovoltaic material BaZrS_(3)

Chalcogenide perovskites(CPs) exhibiting lower band gaps than oxide perovskites and higher stability than halide perovskites are promising materials for photovoltaic and optoelectronic applications. For such applications, the absence of deep defect levels serving as recombination centers(dubbed defect tolerance) is a highly desirable property. Here,using density functional theory(DFT) calculations, we study the intrinsic defects in BaZrS_(3), a representative CP material.We compare Hubbard-U and hybrid functional methods, both of which have been widely used in addressing the band gap problem of semi-local functionals in DFT. We find that tuning the U value to obtain experimental bulk band gap and then using the obtained U value for defect calculations may result in over-localization of defect states. In the hybrid functional calculation, the band gap of BaZrS_(3)can be accurately obtained. We observe the formation of small S-atom clusters in both methods, which tend to self-passivate the defects from forming mid-gap levels. Even though in the hybrid functional calculations several relatively deep defects are observed, all of them exhibit too high formation energy to play a significant role if the materials are prepared under thermal equilibrium.BaZrS_(3)is thus expected to exhibit sufficient defect tolerance promising for photovoltaic and optoelectronic applications.

Ultrafast processes in photochromic material YH_xO_y studied by excited-state density functional theory simulation

Oxygen-containing rare-earth metal hydride YH_xO_y,is a newly found photochromic material showing fast photoresponse.While its preparation method,optical properties and structural features have been studied extensively,the photochromic mechanism in YH_xO_yremains unknown Here,using excited-state molecular dynamics simulation based on the recently developed real-time time-dependent density functional theory(RT-TDDFT)method,we study the photochemical reactions in YH_xO_y.We find that under photoexcitation,dihydrogen defects are formed within 100 fs.The dihydrogen defect behaves as a shallow donor and renders the material strongly n-type doped,which could be responsible for the photochromic effect observed in YH_xO_y.We also find that oxygen concentration affects the metastability of the dihydrogen species,meaning that the energy barrier for the dihydrogen to dissociate is related to the oxygen concentration The highest barrier of 0.28 eV is found in our model with O/Y=1:8.If the oxygen concentration is too low,the dihydrogen will quickly dissociate when the excitation is turned off.If the oxygen concentration is too high,the dihydrogen dissociates even when the excitation is still on.

Using Zhang’s supertension-relieving suture technique with slowly-absorbable barbed sutures in the management of pathological scars:a multicenter retrospective study

Background:An ideal tension-relieving suture should be efficient for>3 months to retrieve normal tensile strength.Most preexisting suturing techniques provided tension elimination followed by relapse and scar proliferation due to absorption and cut-through of the sutures.This study introduces a simple but effective suture technique developed by a senior author(ZYX)to solve this problem.Methods:A total of 120 patients with pathological scar(PS)had intervention treatment with the proposed suturing strategy at three centers from January 2018 to January 2021.A slowly absorbable 2-0 barbed suturewas used for subcutaneous tension relieving with a set-back from the wound edge and a horizontal interval between proposed inserting points of 1 cm.The Patient and Observer Scar Assessment Scale(POSAS),scar width,perfusion and eversion of the wound edge were evaluated at 3-,6-and 12-month follow-up.The time needed to place the tension-relieving suture was recorded and relapse was monitored for 18 months postoperatively.Results:In total,76 trunks,32 extremities and 12 cervical PS were included,with an average subcutaneous tension-relieving suture time of 5 min.The Patient and Observer Scar Assessment Scale(POSAS)score decreased from 84.70±7.06 preoperatively to 28.83±3.09,26.14±1.92 and 24.71±2.00 at 3,6 and 12 months postoperatively,respectively(p<0.0001).The scar widths were 0.17±0.08,0.25±0.09 and 0.33±0.10 cm,respectively,with perfusion significantly decreased from 213.64±14.97 to 112.23±8.18 at 6 months(p<0.0001).The wound edge flattened out during the first 3 months in most cases with only two scar relapses.Conclusions:Zhang’s suture technique provides a rapid and long-lasting tension-relieving effect with ideal scar appearances and lower relapse rates in the surgical management of PS.

Capture efficiency and bias from the defect dynamics near grain boundaries in BCC Fe using mesoscale simulations

The capture efficiency describes the capability of a sink,such as a grain boundary(GB),dislocation,and void,to absorb point defects(PDs).The bias defines the difference in capture efficiency between the absorption of a vacancy and dumbbell at a sink.Complete kinetic information on PDs,including diffusion barriers and diffusion orientations,as well as accurate saddle points,are needed to determine the capture efficiency and bias at a sink accurately,which is computationally demanding.In the present study,the Self-Evolving Atomistic Kinetic Monte Carlo(SEAKMC)method was used to investigate the defect dynamics of PDs near different types of grain boundaries(GBs)(with both 100 and 110 families)accurately in body-centered cubic(BCC)iron(Fe).The capture efficiency,sink strength,and bias factor of different types of GBs were determined in Fe,which,different from traditional rate theory estimation,showed a distinct capture efficiency,sink strength,and bias in different GBs.The results demonstrate a strong positive correlation between the capture efficiency and the GB strain width,instead of the GB misorientation,GB energy,or GB-PD binding energy,which have been investigated previously.This work provides valuable insight into the radiation-induced microstructural evolution of GBs.

Bilinear Forms and Soliton Solutions for the Reduced Maxwell-Bloch Equations with Variable Coefficients in Nonlinear Optics

Investigation in this paper is given to the reduced Maxwell-Bloeh equations with variable coetcients, describing the propagation of the intense ultra-short optical pulses through an inhomogeneous two-level dielectric medium. We apply the Hirota method and symbolic computation to study such equations. With the help of the dependent variable transformations, we present the variable-coetteient-dependent bilinear forms. Then, we construct the one-, two- and N- soliton solutions in analytic forms for them.