A phenology-based vegetation index for improving ratoon rice mapping using harmonized Landsat and Sentinel-2 data

Ratoon rice,which refers to a second harvest of rice obtained from the regenerated tillers originating from the stubble of the first harvested crop,plays an important role in both food security and agroecology while requiring minimal agricultural inputs.However,accurately identifying ratoon rice crops is challenging due to the similarity of its spectral features with other rice cropping systems(e.g.,double rice).Moreover,images with a high spatiotemporal resolution are essential since ratoon rice is generally cultivated in fragmented croplands within regions that frequently exhibit cloudy and rainy weather.In this study,taking Qichun County in Hubei Province,China as an example,we developed a new phenology-based ratoon rice vegetation index(PRVI)for the purpose of ratoon rice mapping at a 30 m spatial resolution using a robust time series generated from Harmonized Landsat and Sentinel-2(HLS)images.The PRVI that incorporated the red,near-infrared,and shortwave infrared 1 bands was developed based on the analysis of spectro-phenological separability and feature selection.Based on actual field samples,the performance of the PRVI for ratoon rice mapping was carefully evaluated by comparing it to several vegetation indices,including normalized difference vegetation index(NDVI),enhanced vegetation index(EVI)and land surface water index(LSWI).The results suggested that the PRVI could sufficiently capture the specific characteristics of ratoon rice,leading to a favorable separability between ratoon rice and other land cover types.Furthermore,the PRVI showed the best performance for identifying ratoon rice in the phenological phases characterized by grain filling and harvesting to tillering of the ratoon crop(GHS-TS2),indicating that only several images are required to obtain an accurate ratoon rice map.Finally,the PRVI performed better than NDVI,EVI,LSWI and their combination at the GHS-TS2 stages,with producer's accuracy and user's accuracy of 92.22 and 89.30%,respectively.These results demonstrate that the proposed PRVI based on HLS data can effectively identify ratoon rice in fragmented croplands at crucial phenological stages,which is promising for identifying the earliest timing of ratoon rice planting and can provide a fundamental dataset for crop management activities.

Method for evaluation of geological strength index of carbonate cliff rocks:Coupled hyperspectral-digital borehole image technique

The deterioration of unstable rock mass raised interest in evaluating rock mass quality.However,the traditional evaluation method for the geological strength index(GSI)primarily emphasizes the rock structure and characteristics of discontinuities.It ignores the influence of mineral composition and shows a deficiency in assessing the integrity coefficient.In this context,hyperspectral imaging and digital panoramic borehole camera technologies are applied to analyze the mineral content and integrity of rock mass.Based on the carbonate mineral content and fissure area ratio,the strength reduction factor and integrity coefficient are calculated to improve the GSI evaluation method.According to the results of mineral classification and fissure identification,the strength reduction factor and integrity coefficient increase with the depth of rock mass.The rock mass GSI calculated by the improved method is mainly concentrated between 40 and 60,which is close to the calculation results of the traditional method.The GSI error rates obtained by the two methods are mostly less than 10%,indicating the rationality of the hyperspectral-digital borehole image coupled evaluation method.Moreover,the sensitivity of the fissure area ratio(Sr)to GSI is greater than that of the strength reduction factor(a),which means the proposed GSI is suitable for rocks with significant fissure development.The improved method reduces the influence of subjective factors and provides a reliable index for the deterioration evaluation of rock mass.

Spectral purification improves monitoring accuracy of the comprehensive growth evaluation index for film-mulched winter wheat

In order to further improve the utility of unmanned aerial vehicle(UAV)remote-sensing for quickly and accurately monitoring the growth of winter wheat under film mulching, this study examined the treatments of ridge mulching,ridge–furrow full mulching, and flat cropping full mulching in winter wheat.Based on the fuzzy comprehensive evaluation (FCE) method, four agronomic parameters (leaf area index, above-ground biomass, plant height, and leaf chlorophyll content) were used to calculate the comprehensive growth evaluation index (CGEI) of the winter wheat, and 14 visible and near-infrared spectral indices were calculated using spectral purification technology to process the remote-sensing image data of winter wheat obtained by multispectral UAV.Four machine learning algorithms, partial least squares, support vector machines, random forests, and artificial neural network networks(ANN), were used to build the winter wheat growth monitoring model under film mulching, and accuracy evaluation and mapping of the spatial and temporal distribution of winter wheat growth status were carried out.The results showed that the CGEI of winter wheat under film mulching constructed using the FCE method could objectively and comprehensively evaluate the crop growth status.The accuracy of remote-sensing inversion of the CGEI based on the ANN model was higher than for the individual agronomic parameters, with a coefficient of determination of 0.75,a root mean square error of 8.40, and a mean absolute value error of 6.53.Spectral purification could eliminate the interference of background effects caused by mulching and soil, effectively improving the accuracy of the remotesensing inversion of winter wheat under film mulching, with the best inversion effect achieved on the ridge–furrow full mulching area after spectral purification.The results of this study provide a theoretical reference for the use of UAV remote-sensing to monitor the growth status of winter wheat with film mulching.

Association between triglyceride-glucose index and colorectal polyps:A retrospective cross-sectional study

BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses metabolic health and insulin resistance,and has been linked to gastrointestinal cancers.AIM To investigate the potential association between the TyG index and CPs,as the relation between them has not been documented.METHODS A total of 2537 persons undergoing a routine health physical examination and colonoscopy at The First People's Hospital of Kunshan,Jiangsu Province,China,between January 2020 and December 2022 were included in this retrospective cross-sectional study.After excluding individuals who did not meet the eligibility criteria,descriptive statistics were used to compare characteristics between patients with and without CPs.Logistic regression analyses were conducted to determine the associations between the TyG index and the prevalence of CPs.The TyG index was calculated using the following formula:Ln[triglyceride(mg/dL)×glucose(mg/dL)/2].The presence and types of CPs was determined based on data from colonoscopy reports and pathology reports.RESULTS A nonlinear relation between the TyG index and the prevalence of CPs was identified,and exhibited a curvilinear pattern with a cut-off point of 2.31.A significant association was observed before the turning point,with an odds ratio(95% confidence interval)of 1.70(1.40,2.06),P<0.0001.However,the association between the TyG index and CPs was not significant after the cut-off point,with an odds ratio(95% confidence interval)of 0.57(0.27,1.23),P=0.1521.CONCLUSION Our study revealed a curvilinear association between the TyG index and CPs in Chinese individuals,suggesting its potential utility in developing colonoscopy screening strategies for preventing CRC.

Renal resistive index measurements by ultrasound in patients with liver cirrhosis:Magnitude and associations with renal dysfunction

BACKGROUND The hemodynamic alterations seen in liver cirrhosis lead to renal vasoconstriction,ultimately causing acute kidney injury(AKI).The renal resistive index(RRI)is the most common Doppler ultrasound variable for measuring intrarenal vascular resistance.AIM To evaluate the association of the RRI with AKI in patients with liver cirrhosis and to identify risk factors for high RRI.METHODS This was a prospective observational study,where RRI was measured using Doppler ultrasound in 200 consecutive hospitalized patients with cirrhosis.The association of RRI with AKI was studied.The receiver operating characteristic(ROC)curve analysis was utilized to determine discriminatory cut-offs of RRI for various AKI phenotypes.Multivariate analysis was conducted to determine the predictors of high RRI.RESULTS The mean patient age was 49.08±11.68 years,with the majority(79.5%)being male;the predominant etiology of cirrhosis was alcohol(39%).The mean RRI for the study cohort was 0.68±0.09,showing a progressive increase with higher Child-Pugh class of cirrhosis.Overall,AKI was present in 129(64.5%)patients.The mean RRI was significantly higher in patients with AKI compared to those without it(0.72±0.06 vs 0.60±0.08;P<0.001).A total of 82 patients(41%)had hepatorenal syndrome(HRS)-AKI,29(22.4%)had prerenal AKI(PRA),and 18(13.9%)had acute tubular necrosis(ATN)-AKI.The mean RRI was significantly higher in the ATN-AKI(0.80±0.02)and HRS-AKI(0.73±0.03)groups than in the PRA(0.63±0.07)and non-AKI(0.60±0.07)groups.RRI demonstrated excellent discriminatory ability in distinguishing ATN-AKI from non-ATN-AKI(area under ROC curve:93.9%).AKI emerged as an independent predictor of high RRI(adjusted odds ratio[OR]:11.52),and high RRI independently predicted mortality among AKI patients(adjusted OR:3.18).CONCLUSION In cirrhosis patients,RRI exhibited a significant association with AKI,effectively differentiated between AKI phenotypes,and predicted AKI mortality.

Three-dimensional choroidal vascularity index and choroidal thickness in fellow eyes of acute and chronic primary angle-closure using swept-source optical coherence tomography

AIM:To compare the three-dimensional choroidal vascularity index(CVI)and choroidal thickness between fellow eyes of acute primary angle-closure(F-APAC)and chronic primary angle-closure glaucoma(F-CPACG)and the eyes of normal controls.METHODS:This study included 37 patients with unilateral APAC,37 with asymmetric CPACG without prior treatment,and 36 healthy participants.Using swept-source optical coherence tomography(SS-OCT),the macular and peripapillary choroidal thickness and three-dimensional CVI were measured and compared globally and sectorally.Pearson’s correlation analysis and multivariate regression models were used to evaluate choroidal thickness or CVI with related factors.RESULTS:The mean subfoveal CVIs were 0.35±0.10,0.33±0.09,and 0.29±0.04,and the mean subfoveal choroidal thickness were 315.62±52.92,306.22±59.29,and 262.69±45.55μm in the F-APAC,F-CPACG,and normal groups,respectively.All macular sectors showed significantly higher CVIs and choroidal thickness in the F-APAC and F-CPACG eyes than in the normal eyes(P<0.05),while there were no significant differences between the F-APAC and F-CPACG eyes.In the peripapillary region,the mean overall CVIs were 0.21±0.08,0.20±0.08,and 0.19±0.05,and the mean overall choroidal thickness were 180.45±54.18,174.82±50.67,and 176.18±37.94μm in the F-APAC,F-CPACG,and normal groups,respectively.There were no significant differences between any of the two groups in all peripapillary sectors.Younger age,shorter axial length,and the F-APAC or F-CPACG diagnosis were significantly associated with higher subfoveal CVI and thicker subfoveal choroidal thickness(P<0.05).CONCLUSION:The fellow eyes of unilateral APAC or asymmetric CPACG have higher macular CVI and choroidal thickness than those of the normal controls.Neither CVI nor choroidal thickness can distinguish between eyes predisposed to APAC or CPACG.A thicker choroid with a higher vascular volume may play a role in the pathogenesis of primary angle-closure glaucoma.

On traceable iterated line graph and hamiltonian path index

Xiong and Liu[21]gave a characterization of the graphs G for which the n-iterated line graph L^(n)(G)is hamiltonian,for n≥2.In this paper,we study the existence of a hamiltonian path in L^(n)(G),and give a characterization of G for which L^(n)(G)has a hamiltonian path.As applications,we use this characterization to give several upper bounds on the hamiltonian path index of a graph.

Plasma nitrogen fixation system with dual-loop enhancement for improved energy efficiency and its efficacy for lettuce cultivation

Plasma nitrogen fixation(PNF)has been emerging as a promising technology for greenhouse gasfree and renewable energy-based agriculture.Yet,most PNF studies seldom address practical application-specific issues.In this work,we present the development of a compact and automatic PNF system for on-site agricultural applications.The system utilized a gliding-arc discharge as the plasma source and employed a dual-loop design to generate NO_(x)from air and water under atmospheric conditions.Experimental results showed that the system with a dualloop design performs well in terms of energy costs and production rates.Optimal operational parameters for the system were determined through experimentation,resulting in an energy cost of 13.9 MJ mol^(-1)and an energy efficiency of 16 g kWh^(-1)for NO_(3)^(-)production,respectively.Moreover,the concentration of exhausted NO_(x)was below the emission standards.Soilless lettuce cultivation experiments demonstrated that NO_(x)^(-)produced by the PNF system could serve as liquid nitrate nitrogen fertilizer.Overall,our work demonstrates the potential of the developed PNF system for on-site application in the production of green-leaf vegetables.

Association between the cumulative triglyceride-glucose index and the recurrence of atrial fibrillation after radiofrequency catheter ablation

BACKGROUND Triglyceride-glucose(TyG)index values are a new surrogate marker for insulin resistance.This study aimed to explore the relationship between cumulative TyG index values and atrial fibrillation(AF)recurrence after radiofrequency catheter ablation(RFCA).METHODS A total of 576 patients with AF who underwent RFCA at the Second Affiliated Hospital of Xi'an Jiaotong University were included in this study.The participants were grouped based on cumulative TyG index values tertiles within 3 months after ablation.Cox regression and restricted cubic spline analyses were used to determine the relationship between cumulative TyG index values and AF recurrence.The predictive value of all risk factors was assessed by receiver operating curve analysis.RESULTS There were 375 patients completed the study(age:63.23±10.73 years,64.27%male).The risk of AF recurrence increased with increasing cumulative TyG index values tertiles.After adjusting for potential confounders,patients in the medium cumulative TyG index group[hazard ratio(HR)=4.949,95%CI:1.778–13.778,P=0.002]and the high cumulative TyG index group(HR=8.716,95%CI:3.371–22.536,P<0.001)had a higher risk of AF recurrence than those in the low cumulative TyG index group.The restricted cubic spline regression model also showed an increased risk of AF recurrence with increasing cumulative TyG index values.When considering cumulative TyG index values,left atrial diameter,and lactate dehydrogenase levels as a comprehensive factor,the model could effectively predict AF recurrence after RFCA[area under the curve(AUC)=0.847,95%CI:0.797–0.897,P<0.001].CONCLUSIONS Cumulative TyG index values were a risk factor for AF recurrence after RFCA.Monitoring longitudinal TyG index values may assist with optimized for risk stratification and outcome prediction for AF recurrence.

An evaluation of ureteral diameter ratio and vesicoureteral reflux index in the treatment of primary vesicoureteral reflux

Objective:Vesicoureteral reflux(VUR)index is a simple,validated tool that reliably predicts significant improvement and spontaneous resolution of primary reflux in children.The aim of this study was to evaluate and compare the ureter diameter ratio(UDR)and VUR index(VURx)of patients treated with endoscopic injection(EI)and ureteroneocystostomy(UNC)methods in the pediatric age group due to primary VUR.Methods:Patients under the age of 18 years old who underwent EI and UNC with the diagnosis of primary VUR between January 2011 and September 2021 were determined as the participants.The UDR was assessed using voiding cystourethrography,and the VURx score was determined prior to treatment based on hospital records included in the study.Results:A total of 255 patients,60(23.5%)boys and 195(76.5%)girls,with a mean age of 76.5(range 13.0e204.0)months,were included in the study.EI was applied to 130(51.0%)patients and UNC was applied to 125(49.0%)patients due to primary VUR.The optimum cut-off for the distal UDR was obtained as 0.17 with sensitivity and specificity of 73.0%and 63.0%,respectively.The positive and negative predictive values were 66.0%and 70.0%,respectively.Conclusion:When the UDR and VURx score are evaluated together for the surgical treatment of primary VUR in the pediatric age group,it is thought that it may be useful in predicting the clinical course of the disease and evaluating surgical treatment options.

Assessment on eco-environmental quality of the Yellow River Basin by considering desertification index

Desertification has had a significant impact on the ecological environment of the Yellow River Basin(YRB)in China.However,previous studies on the evaluation of the ecological environment quality(EEQ)in the YRB have paid limited attention to the indicator of desertification.It is of great significance to incorporate the desertification index into the spatiotemporal assessment of the EEQ in the YRB in order to protect the ecological environment in the region.In this study,based on multi-source remote sensing data from 91 cities in the YRB,this article proposes a desertification remote sensing ecological index(DRSEI)model,which builds upon the traditional Remote Sensing Ecological Index(RSEI)model,to analyze the spatiotemporal changes in the EEQ in the YRB from 2001 to 2021.Furthermore,using the geographic detector(GD),and geographically and temporally weighted regression(GTWR)model,the study assesses the impact of human and natural factors on the EEQ in the YRB.The research findings indicate that:(1)Compared to the traditional RSEI,the improved DRSEI shows a decreasing trend in the evaluation results of the EEQ.Among the 24 cities,the change in DRSEI exceeds 0.05 compared to RSEI,accounting for 26.37%of the YRB.The remaining 67 cities have changes within a range of less than 0.05,accounting for 73.63%of the YRB.(2)The results of the GD for individual and interactive effects reveal that rainfall and elevation have significant individual and interactive effects on the EEQ.Furthermore,after the interaction with natural factors,the explanatory power of human factors gradually increases over time.The spatial heterogeneity results of GTWR demonstrate that rainfall has a strong direct positive impact on the EEQ,accounting for 98.90%of the influence,while temperature exhibits a more pronounced direct inhibitory effect,accounting for 76.92%of the influence.Human activities have a strong negative impact on the EEQ and a weak positive impact.

Strawberry (Fragaria spp.): Cultivation, Production, Consumption, and Marketing in Cameroon

Strawberry (Fragaria spp.) is one of the most important fruits classified as exotic fruits imported into Cameroon. To have an inventory of its cultivation in Cameroon, a survey study was carried out among eight farms of Fragaria spp. from January 2021 to February 2022. The plant was introduced in Cameroon in 2018. There are 13 varieties of Fragaria spp. currently cultivated. Among these 13 varieties, eleven are hybrids of Fragaria x ananassa (“Amiga”, “Amine”, “Camarosa”, “Chandler”, “Charlotte”, “Elsanta”, “Gariguette”, “Madame Moutot”, “Ostara”, “Ruby gem” and “San Andreas”), and two of the hybrids of Fragaria vesca (“Maestro” and “Mara des bois”). The cropping system, irrigation system, and type of fertilizers applied differ from one strawberry farm to another. Biofertilizers (such as mycorrhizal), inorganic and organic fertilizers are actually used to improve production. The potential annual production of strawberries from January 2021 to February 2022, estimated based on the survey data, was 21.216 tons for all growers. Among these eight production farms, the Lolodorf BIO Farm presents 6000 kg (six tons) of strawberries and 100,000 stolons (seedlings) produced, from seven varieties of Fragaria spp. cultivated, with 6 varieties which are hybrids variety Fragaria x ananassa (“Amiga”, “Amine”, “Chandler”, “Gariguette”, “Madame Moutot”, and “Ruby gem”), and one which is a hybrid of Fragaria vesca (“Mara des bois”). Certain diseases were also observed and recorded depending on the growing areas.

Cultivation Path of Nursing Undergraduates’Scientific Research and Innovation Ability

Objective: The cultivation of the innovation ability and scientific research is one of the nursing learning objectives for undergraduate students. To explore the method and effect of training system of scientific research innovation ability of nursing undergraduates based on “3332”. Methods: Three course learning modules are constructed: stage-based course learning module, systematic project practice training module and comprehensive practice training module. A practical training platform for scientific research innovation projects is built, and undergraduate scientific research innovation ability training is carried out from both in-class and out-of-class lines. Results: Since 2017, the students have obtained 7 national innovation and entrepreneurship training programs, 52 university-level undergraduate scientific research projects, published more than 10 academic papers, and obtained 2 patent authorization. Conclusions: The training system of scientific research innovation ability of nursing undergraduates based on “3332” is conducive to the development of scientific research innovation ability of nursing students, and to cultivate nursing talents who can adapt to the development of the new era and have better post competence.

The response of roots and the rhizosphere environment to integrative cultivation practices in paddy rice

Integrative cultivation practices(ICPs)are essential for enhancing cereal yield and resource use efficiency.However,the effects of ICP on the rhizosphere environment and roots of paddy rice are still poorly understood.In this study,four rice varieties were produced in the field.Each variety was treated with six different cultivation techniques,including zero nitrogen application(0 N),local farmers’practice(LFP),nitrogen reduction(NR),and three progressive ICP techniques comprised of enhanced fertilizer N practice and increased plant density(ICP1),a treatment similar to ICP1 but with alternate wetting and moderate drying instead of continuous flooding(ICP2),and the same practices as ICP2 with the application of organic fertilizer(ICP3).The ICPs had greater grain production and nitrogen use efficiency than the other three methods.Root length,dry weight,root diameter,activity of root oxidation,root bleeding rate,zeatin and zeatin riboside compositions,and total organic acids in root exudates were elevated with the introduction of the successive cultivation practices.ICPs enhanced nitrate nitrogen,the activities of urease and invertase,and the diversity of microbes(bacteria)in rhizosphere and non-rhizosphere soil,while reducing the ammonium nitrogen content.The nutrient contents(ammonium nitrogen,total nitrogen,total potassium,total phosphorus,nitrate,and available phosphorus)and urease activity in rhizosphere soil were reduced in all treatments in comparison with the non-rhizosphere soil,but the invertase activity and bacterial diversity were greater.The main root morphology and physiology,and the ammonium nitrogen contents in rhizosphere soil at the primary stages were closely correlated with grain yield and internal nitrogen use efficiency.These findings suggest that the coordinated enhancement of the root system and the environment of the rhizosphere under integrative cultivation approaches may lead to higher rice production.

Detection of Bisphenol A (BPA) in Plastic Bottles Using Vertical Cultivation at Various Temperatures

Polycarbonate plastics containing bisphenol A (BPA) used to manufacture drinking water bottles. Kurdistan region in northern Iraq is a developed area with increased pollution from plastic bottles. Trace amounts of BPA have been detected in bottled water samples. The absorption of BPA was measured with HPLC using a vertical cultivation system with Bulbs of the Allium Cepa plant planted in these plastic bottles with monitored growth. Vertical cultivation was found to have a low level of BPA in the plant cells, making it a safe cultivation method under specific climate conditions. The mean concentration of BPA in vertical cultivation is 0.19 ug/ml (3.8 ng for a 20 uL injection), and the Limit of Quantification (LOQ) is 0.63 ug/ml (12.7 ng for 20 uL injection). While Scanning Electron Microscope (SEM) shows that the concentrations are relatively low in water samples stored at room temperature compared to those exposed to direct sunlight (40°C) and water bottle samples stored at (-4°C), The correlation coefficients were found to be good (0.9992). SEM is used for plastic bottle samples stored at different temperatures. The images identify compound decay and explore the morphology of BPA in manufactured plastic materials.

Determinants of Tobacco Cultivation and the Associated Impacts of Adoption in Hurungwe District, Zimbabwe

Tobacco is an essential cash crop in Zimbabwe and a strategic livelihood option for hundreds of thousands of rural households. However, the crop is linked to negative environmental, economic, and social impacts. The existing studies on tobacco cultivation in Zimbabwe present contradictory findings on the determinants and impacts of adoption, leaving unanswered questions about the crop’s sustainability impact in the country. This article investigates the determinants of smallholder farmers’ decisions to grow tobacco and the associated impacts of adoption. Random and purposive sampling were used to select 273 household surveys, including tobacco and non-tobacco smallholder farmers, and 56 expert interviews to answer the research questions. We employed regression models alongside expert interviews and document analysis to identify the determinants influencing the decision-making process of smallholder farmers in Zimbabwe regarding tobacco cultivation. Additionally, our investigation aimed to elucidate the perceived impacts associated with the adoption of this agricultural practice. The regression analysis indicated that the farmer’s age, education level, farming experience, family size, household income, and perceived high farm profitability are significant drivers of tobacco adoption. We also discovered divergent and convergent perceptions of the critical impacts of tobacco cultivation. The study highlights the need for proactive multi-stakeholder collaboration and sustainable financial arrangements to address the negative impacts of tobacco production. As the primary stakeholder responsible for regulating and promoting agricultural activities, the Zimbabwean government should provide meaningful financial support, increase access to credit, and ensure better market facilities for alternative crops to reduce the over-dependence on tobacco.

Early peripheral perfusion index predicts 28-day outcome in patients with septic shock

BACKGROUND:To investigate the prognostic value of the peripheral perfusion index(PPI)in patients with septic shock.METHODS:This prospective cohort study,conducted at the emergency intensive care unit of Peking University People's Hospital,recruited 200 patients with septic shock between January 2023 and August 2023.These patients were divided into survival(n=84)and death(n=116)groups based on 28-day outcomes.Clinical evaluations included laboratory tests and clinical scores,with lactate and PPI values assessed upon admission to the emergency room and at 6 h and 12 h after admission.Risk factors associated with mortality were analyzed using univariate and multivariate Cox regression analyses.Receiver operator characteristic(ROC)curve was used to assess predictive performance.Mortality rates were compared,and Kaplan-Meier survival plots were created.RESULTS:Compared to the survival group,patients in the death group were older and had more severe liver damage and coagulation dysfunction,necessitating higher norepinephrine doses and increased fl uid replacement.Higher lactate levels and lower PPI levels at 0 h,6 h,and 12 h were observed in the death group.Multivariate Cox regression identifi ed prolonged prothrombin time(PT),decreased 6-h PPI and 12-h PPI as independent risk factors for death.The area under the curves for 6-h PPI and 12-h PPI were 0.802(95%CI 0.742-0.863,P<0.001)and 0.945(95%CI 0.915-0.974,P<0.001),respectively,which were superior to Glasgow Coma Scale(GCS),Sequential Organ Failure Assessment(SOFA)scores(0.864 and 0.928).Cumulative mortality in the low PPI groups at 6 h and 12 h was signifi cantly higher than in the high PPI groups(6-h PPI:77.52%vs.22.54%;12-h PPI:92.04%vs.13.79%,P<0.001).CONCLUSION:PPI may have value in predicting 28-day mortality in patients with septic shock.

Actuality and underlying mechanisms of systemic immuneinflammation index and geriatric nutritional risk index prognostic value in hepatocellular carcinoma

This editorial contains comments on the article“Correlation between preoperative systemic immune inflammation index,nutritional risk index,and prognosis of radical resection of liver cancer”in a recent issue of the World Journal of Gastrointestinal Surgery.It pointed out the actuality and importance of the article and focused primarily on the underlying mechanisms making the systemic immuneinflammation index(SII)and geriatric nutritional risk index(GNRI)prediction features valuable.There are few publications on both SII and GNRI together in hepatocellular carcinoma(HCC)and patient prognosis after radical surgery.Neutrophils release cytokines,chemokines,and enzymes,degrade extracellular matrix,reduce cell adhesion,and create conditions for tumor cell invasion.Neutrophils promote the adhesion of tumor cells to endothelial cells,through physical anchoring.That results in the migration of tumor cells.Pro-angiogenic factors from platelets enhance tumor angiogenesis to meet tumor cell supply needs.Platelets can form a protective film on the surface of tumor cells.This allows avoiding blood flow damage as well as immune system attack.It also induces the epithelial-mesenchymal transformation of tumor cells that is critical for invasiveness.High SII is also associated with macro-and microvascular invasion and increased numbers of circulating tumor cells.A high GNRI was associated with significantly better progression-free and overall survival.HCC patients are a very special population that requires increased attention.SII and GNRI have significant survival prediction value in both palliative treatment and radical surgery settings.The underlying mechanisms of their possible predictive properties lie in the field of essential cancer features.Those features provide tumor nutrition,growth,and distribution throughout the body,such as vascular invasion.On the other hand,they are tied to the possibility of patients to resist tumor progression and development of complications in both postoperative and cancer-related settings.The article is of considerable interest.It would be helpful to continue the study follow-up to 2 years and longer.External validation of the data is needed.

Advancing prognostic precision in gastric cancer with an immunoinflammatory index

Gastric cancer remains a major global health challenge with high morbidity and mortality rates.Recent advancements in immunology and inflammation research have highlighted the crucial roles that these biological processes play in tumor progression and patient outcomes.This has sparked new interest in developing prognostic biomarkers that integrate these two key biological processes.In this letter,we discuss the recent study by Ba et al,which proposed a novel prognostic immunoinflammatory index for patients with gastric cancer.We underscore the importance of this research,its potential impact on medical practice,and the prospective avenues for further investigation in this rapidly emerging area of study.

Strategic insights into the cultivation of pancreatic cancer organoids from endoscopic ultrasonography-guided biopsy tissue

BACKGROUND The frequent suboptimal efficacy of endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB)to culture pancreatic cancer(PC)organoids(PCOs)poses a major challenge in the advancement of personalized medicine for advanced PC.AIM To explore how to obtain appropriate puncture tissues from EUS-FNB and optimize the strategy for efficiently constructing PCOs,providing an efficient tool for the advancement of personalized medicine.METHODS Patients who underwent EUS-FNB for the diagnosis of PC tissue were prospectively enrolled.We refined the endoscopic biopsy procedures and organoid cultivation techniques.All tissue specimens verified by on-site pathological assessment were cultured in a semi-suspended medium in a microfluidic environment.We assessed differences in PCOs cultured beyond and below five generations examining patient demographics,specimen and organoid attributes,and the sensitivity of organoids to a panel of clinical drugs through cell viability assays.RESULTS In this study,16 patients with PC were recruited,one sample was excluded because onsite cytopathology showed no tumor cells.Successful organoid generation occurred in 93.3%(14 of 15)of the EUS-FNB specimens,with 60%(9 of 15)sustaining over five generations.Among these patients,those with a history of diabetes,familial cancer,or larger tumors exhibited enhanced PCO expandability.The key factors influencing longterm PCOs expansion included initial needle sample quality(P=0.005),rapid initiation of organoid culture postisolation(P≤0.001),and high organoid activity(P=0.031).Drug sensitivity analysis revealed a partial response in two patients following therapeutic intervention and surgery and stable disease in four patients,indicating a moderate correlation between organoid response and clinical outcomes.CONCLUSION Optimal initial needle sampling,rapid and precise biopsy sample processing,process isolated samples as soon as possible,and sufficient cellular material are crucial for successful cultivating PCOs.High organoid activity is an important factor in maintaining their long-term expansion,which is essential for shortening the time of drug sensitivity analysis and is the basis of PC research.