Role of intravascular ultrasound and optical coherence tomography in intracoronary imaging for coronary artery disease:a systematic review

Coronary angiography has long been the standard for coronary imaging,but it has limitations in assessing vessel wall anatomy and guiding percutaneous coronary intervention(PCI).Intracoronary imaging techniques like intravascular ultrasound(IVUS)and optical coherence tomography(OCT)can overcome these limitations.IVUS uses ultrasound and OCT uses near-infrared light to visualize coronary pathology in unique ways due to differences in temporal and spatial resolution.These techniques have evolved to offer clinical utility in plaque characterization and vessel assessment during PCI.Meta-analyses and adjusted observational studies suggest that both IVUS and OCT-guided PCI correlate with reduced cardiovascular risks compared to angiographic guidance alone.While IVUS demonstrates consistent clinical outcome benefits,OCT evidence is less robust.IVUS has progressed from early motion detection to high-resolution systems,with smaller compatible catheters.OCT utilizes near infrared light to achieve unparalleled resolutions,but requires temporary blood clearance for optimal imaging.Enhanced visualization and guidance make IVUS and OCT well-suited for higher risk PCI in patients with diabetes and chronic kidney disease by allowing detailed visualization of complex lesions and ensuring optimal stent deployment and positioning in PCI for patients with type 2 diabetes and chronic kidney disease,improving outcomes.IVUS and recent advancements in zero-and low-contrast OCT techniques can reduce nephrotoxic contrast exposure,thus helping to minimize PCI complications in these high-risk patient groups.IVUS and OCT provide valuable insights into coronary pathophysiology and guide interventions precisely compared to angiography alone.Both have comparable clinical outcomes,emphasizing the need for tailored imaging choices based on clinical scenarios.Continued refinement and integration of intravascular imaging will likely play a pivotal role in optimizing coronary interventions and outcomes.This systematic review aims to delve into the nuances of IVUS and OCT,highlighting their strengths and limitations as PCI adjuncts.

Measurement of very low-molecular weight metabolites by traveling wave ion mobility and its use in human urine samples

The collision cross-sections(CCS)measurement using ion mobility spectrometry(IMS)in combination with mass spectrometry(MS)offers a great opportunity to increase confidence in metabolite identification.However,owing to the lack of sensitivity and resolution,IMS has an analytical challenge in studying the CCS values of very low-molecular-weight metabolites(VLMs250 Da).Here,we describe an analytical method using ultrahigh-performance liquid chromatography(UPLC)coupled to a traveling wave ion mobility-quadrupole-time-of-flight mass spectrometer optimized for the measurement of VLMs in human urine samples.The experimental CCS values,along with mass spectral properties,were reported for the 174 metabolites.The experimental data included the mass-to-charge ratio(m/z),retention time(RT),tandem MS(MS/MS)spectra,and CCS values.Among the studied metabolites,263 traveling wave ion mobility spectrometry(TWIMS)-derived CCS values(TWCCSN2)were reported for the first time,and more than 70%of these were CCS values of VLMs.The TWCCSN2 values were highly repeatable,with inter-day variations of<1%relative standard deviation(RSD).The developed method revealed excellent TWCCSN2 accuracy with a CCS difference(DCCS)within±2%of the reported drift tube IMS(DTIMS)and TWIMS CCS values.The complexity of the urine matrix did not affect the precision of the method,as evidenced by DCCS within±1.92%.According to the Metabolomics Standards Initiative,55 urinary metabolites were identified with a confidence level of 1.Among these 55 metabolites,53(96%)were VLMs.The larger number of confirmed compounds found in this study was a result of the addition of TWCCSN2 values,which clearly increased metabolite identification confidence.

Genetic Optimization via Diverse Crossover Intelligence

An intelligent crossover methodology within the genetic algorithm (GA) is explored within both mathematical and finite element arenas improving both design and solution convergence time. This improved intelligent crossover outperforms the traditional genetic algorithm combined with a rule-based approach utilizing domain specific knowledge developed by Webb, et al. [1]. The encoding of the improved crossover consists of two chromosome strings within the genetic algorithm where the first string represents the design or solution string, and the second string represents chromosome crossover string intelligence. This improved crossover methodology saves the best population members or designs evaluated from each generation and applies crossover chromosome intelligence to the best saved population members paired with globally selected parents. Enhanced features of this crossover methodology employ the random selection of the best designs from the prior generation as a potential parent coupled with alternating intelligence pairing methods. In addition to this approach, two globally selected parents possess the ability to mate utilizing crossover chromosome string intelligence maintaining the integrity of a global GA search. Overall, the final population following crossover employs both global and best generation design chromosome strings to maximize creativity while enhancing the solution search. This is a modification to a conventional GA that can be translated into GA encoding. This technique is explored initially through a Base 10 mathematical application followed by the examination of plate structural optimization considering stress and displacement constraints. Results from crossover intelligence are compared with the conventional genetic algorithm and from Webb, et al. [1] which illustrates the outcome of a two phase genetic optimization algorithm.

Game Theory Optimization via Diverse Genetic Crossover Intelligence

Game theory is explored via a maze application where combinatorial optimization occurs with the objective of traversing through a defined maze with an aim to enhance decision support and locate the optimal travel sequence while minimizing computation time. This combinatorial optimization approach is initially demonstrated by utilizing a traditional genetic algorithm (GA), followed by the incorporation of artificial intelligence utilizing embedded rules based on domain-specific knowledge. The aim of this initiative is to compare the results of the traditional and rule-based optimization approaches with results acquired through an intelligent crossover methodology. The intelligent crossover approach encompasses a two-dimensional GA encoding where a second chromosome string is introduced within the GA, offering a sophisticated means for chromosome crossover amongst selected parents. Additionally, parent selection intelligence is incorporated where the best-traversed paths or population members are retained and utilized as potential parents to mate with parents selected within a traditional GA methodology. A further enhancement regarding the utilization of saved optimal population members as potential parents is mathematically explored within this literature.

Remimazolam for sedation in gastrointestinal endoscopy:A comprehensive review

Worldwide,a majority of routine endoscopic procedures are performed under some form of sedation to maximize patient comfort.Propofol,benzodiazepines and opioids continue to be widely used.However,in recent years,Remimazolam is gaining immense popularity for procedural sedation in gastrointestinal(GI)endoscopy.It is an ultra-short-acting benzodiazepine sedative which was approved by the Food and Drug Administration in July 2020 for use in procedural sedation.Remimazolam has shown a favorable pharmacokinetic and pharmacodynamic profile in terms of its non-specific metabolism by tissue esterase,volume of distribution,total body clearance,and negligible drug-drug interactions.It also has satisfactory efficacy and has achieved high rates of successful sedation in GI endoscopy.Furthermore,studies have demonstrated that the efficacy of Remimazolam is non-inferior to Propofol,which is currently a gold standard for procedural sedation in most parts of the world.However,the use of Propofol is associated with hemodynamic instability and respiratory depression.In contrast,Remimazolam has lower incidence of these adverse effects intra-procedurally and hence,may provide a safer alternative to Propofol in procedural sedation.In this comprehensive narrative review,highlight the pharmacologic characteristics,efficacy,and safety of Remimazolam for procedural sedation.We also discuss the potential of Remimazolam as a suitable alternative and how it can shape the future of procedural sedation in gastroenterology.

Sepsis during short bowel syndrome hospitalizations:Identifying trends,disparities,and clinical outcomes in the United States

BACKGROUND Short bowel syndrome(SBS)hospitalizations are often complicated with sepsis.There is a significant paucity of data on adult SBS hospitalizations in the United States and across the globe.AIM To assess trends and outcomes of SBS hospitalizations complicated by sepsis in the United States.METHODS The National Inpatient Sample was utilized to identify all adult SBS hospitalizations between 2005-2014.The study cohort was further divided based on the presence or absence of sepsis.Trends were identified,and hospitalization characteristics and clinical outcomes were compared.Predictors of mortality for SBS hospitalizations complicated with sepsis were assessed.RESULTS Of 247097 SBS hospitalizations,21.7%were complicated by sepsis.Septic SBS hospitalizations had a rising trend of hospitalizations from 20.8%in 2005 to 23.5%in 2014(P trend<0.0001).Compared to non-septic SBS hospitalizations,septic SBS hospitalizations had a higher proportion of males(32.8%vs 29.3%,P<0.0001),patients in the 35-49(45.9%vs 42.5%,P<0.0001)and 50-64(32.1%vs 31.1%,P<0.0001)age groups,and ethnic minorities,i.e.,Blacks(12.4%vs 11.3%,P<0.0001)and Hispanics(6.7%vs 5.5%,P<0.0001).Furthermore,septic SBS hospitalizations had a higher proportion of patients with intestinal transplantation(0.33%vs 0.22%,P<0.0001),inpatient mortality(8.5%vs 1.4%,P<0.0001),and mean length of stay(16.1 d vs 7.7 d,P<0.0001)compared to the non-sepsis cohort.A younger age,female gender,White race,and presence of comorbidities such as anemia and depression were identified to be independent predictors of inpatient mortality for septic SBS hospitalizations.CONCLUSION Septic SBS hospitalizations had a rising trend between 2005-2014 and were associated with higher inpatient mortality compared to non-septic SBS hospitalizations.

Clinical outcomes in patients diagnosed with extra-nodal Hodgkin lymphoma: a 20-year retrospective analysis of the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database

Background:Hodgkin lymphoma refers to a malignancy of the lymphatic tissue.Extra-nodal Hodgkin lymphoma(ENHL)is a rare variant consisting of Hodgkin lymphoma occurring outside the lymphatic system.Studies investigating the epidemiology associated with ENHL are rare.Methods:618 ENHL cases were analyzed using the National Cancer Institute’s Surveillance,Epidemiology,and End Results(SEER)database(2000–2020).Demographics including sex,race/ethnicity,rural-urban continuum,age group(categorized as adolescent and young adult(AYA)if between years of 15 and 39,and adult if over the age of 40),and living status(alive/deceased)were examined,with survival status as the main outcome.Results:This study included 335 males(54.2%)and 283 females(45.8%).Of this total,47.9%were in the AYA group.In terms of ethnicity the distribution was 12.5%non-Hispanic Black,67.5%non-Hispanic White,5.2%non-Hispanic Asian/Pacific Islander,and 14.9%Hispanic.Bivariate analyses evidenced significant differences in survival by age group with 91.6%in AYA vs.72.4%in adults(P<0.001)alive by the end of the study period.Multivariable analyses identified age as a key predictor of survival,as the AYA patients had a lower odds ratio for death(odds ratio=0.25,P<0.001).In addition,survival outcomes were also impacted by race,with non-Hispanic Blacks showing higher survival probabilities.Regarding treatment,27.0%of patients underwent surgery,with 10.2%receiving post-surgery radiation,reducing odds of mortality(odds ratio=0.32,P=0.046).Conclusion:The background research as such,tends to affirm that these two factors–age and race are quite crucial in the prognosis as well as management of ENHL.Compared to adults,AYA patients had significantly lower odds of death,while non-Hispanic Black individuals exhibited reduced survival probabilities.It should be noted that 27.0%of patients underwent surgery with 10.2%receiving post-operative radiation which led to decrease in mortality rates.Thus,these results reiterate the necessity for tailor-made treatment methods according to demographic characteristics to boost patient outcomes effectively.For better ENHL care,future studies could shed light on these disparities and improve treatment regimens as needed.

Experimental and Theoretical Research Review of Hybrid Rocket Motor Techniques and Applications

A hybrid rocket motor combines components from both solid fuel and liquid fuel rocket motors. The fuel itself is a solid grain, (often paraffin or hydroxyl-terminated polybutadiene, known as HTPB) while the oxidizing agent is liquid (often hydrogen peroxide or liquid oxygen). These components are combined in the fuel chamber which doubles as the combustion chamber for the hybrid motor. This review looks at the advances in techniques that have taken place in the development of these motors since 1995. Methods of testing the thrust from rocket motors and of measuring the rocket plume spectroscopically for combustion reaction products have been developed. These assessments allow researchers to more completely understand the effects of additives and physical changes in design, in terms of regression rates and thrust developed. Hybrid rocket motors have been used or tested in many areas of rocketry, including tactical rockets and large launch vehicles. Several additives have shown significant improvements in regression rates and thrust, including Guanidinium azotetrazolate (GAT), and various Aluminum alloys. The most recent discoveries have come from research into nano-particle additives. The nano-particles have been shown to provide enhancements to many parameters of hybrid rocket function, and research into specific areas continues in the sub-field of nano-additives for fuel grains.

Cost analysis of childhood glaucoma surgeries using the US Medicaire allowable costs

AIM: To analyze and calculate the relative cost of various childhood glaucoma surgical interventions per mm Hg intraocular pressure(IOP) reduction($/mm Hg).METHODS: Representative index studies were reviewed to quantitate the reduction of mean IOP and glaucoma medications for each surgical intervention in childhood glaucoma. A US perspective was adopted, using Medicare allowable costs to calculate cost/mm Hg IOP reduction($/mm Hg) at 1y postoperatively.RESULTS: At 1y postoperatively, the cost/mm Hg IOP reduction was $226/mm Hg for microcatheter-assisted circumferential trabeculotomy, $284/mm Hg for cyclophotocoagulation, $288/mm Hg for conventional ab-externo trabeculotomy, $338/mm Hg for Ahmed glaucoma valve, $350/mm Hg for Baerveldt glaucoma implant, $351/mm Hg for goniotomy, and $400/mm Hg for trabeculectomy.CONCLUSION: Microcatheter-assisted circumferential trabeculotomy is the most cost-efficient surgical method to lower IOP in childhood glaucoma, while trabeculectomy is the least cost-efficient surgical method.

Gut microbiome supplementation as therapy for metabolic syndrome

The gut microbiome is defined as an ecological community of commensal symbiotic and pathogenic microorganisms that exist in our body.Gut microbiome dysbiosis is a condition of dysregulated and disrupted intestinal bacterial homeostasis,and recent evidence has shown that dysbiosis is related to chronic inflammation,insulin resistance,cardiovascular diseases(CVD),type 2 diabetes mellitus(T2DM),and obesity.It is well known that obesity,T2DM and CVD are caused or worsened by multiple factors like genetic predisposition,environmental factors,unhealthy high calorie diets,and sedentary lifestyle.However,recent evidence from human and mouse models suggest that the gut microbiome is also an active player in the modulation of metabolic syndrome,a set of risk factors including obesity,hyperglycemia,and dyslipidemia that increase the risk for CVD,T2DM,and other diseases.Current research aims to identify treatments to increase the number of beneficial microbiota in the gut microbiome in order to modulate metabolic syndrome by reducing chronic inflammation and insulin resistance.There is increasing interest in supplements,classified as prebiotics,probiotics,synbiotics,or postbiotics,and their effect on the gut microbiome and metabolic syndrome.In this review article,we have summarized current research on these supplements that are available to improve the abundance of beneficial gut microbiota and to reduce the harmful ones in patients with metabolic syndrome.

Recent advances in endoscopic management of gastric neoplasms

The development and clinical application of new diagnostic endoscopic technologies such as endoscopic ultrasonography with biopsy,magnification endoscopy,and narrow-band imaging,more recently supplemented by artificial intelligence,have enabled wider recognition and detection of various gastric neoplasms including early gastric cancer(EGC)and subepithelial tumors,such as gastrointestinal stromal tumors and neuroendocrine tumors.Over the last decade,the evolution of novel advanced therapeutic endoscopic techniques,such as endoscopic mucosal resection,endoscopic submucosal dissection,endoscopic fullthickness resection,and submucosal tunneling endoscopic resection,along with the advent of a broad array of endoscopic accessories,has provided a promising and yet less invasive strategy for treating gastric neoplasms with the advantage of a reduced need for gastric surgery.Thus,the management algorithms of various gastric tumors in a defined subset of the patient population at low risk of lymph node metastasis and amenable to endoscopic resection,may require revision considering upcoming data given the high success rate of en bloc resection by experienced endoscopists.Moreover,endoscopic surveillance protocols for precancerous gastric lesions will continue to be refined by systematic reviews and meta-analyses of further research.However,the lack of familiarity with subtle endoscopic changes associated with EGC,as well as longer procedural time,evolving resection techniques and tools,a steep learning curve of such high-risk procedures,and lack of coding are issues that do not appeal to many gastroenterologists in the field.This review summarizes recent advances in the endoscopic management of gastric neoplasms,with special emphasis on diagnostic and therapeutic methods and their future prospects.

Four-Order Superconvergent Weak Galerkin Methods for the Biharmonic Equation on Triangular Meshes

A stabilizer-free weak Galerkin(SFWG)finite element method was introduced and analyzed in Ye and Zhang(SIAM J.Numer.Anal.58:2572–2588,2020)for the biharmonic equation,which has an ultra simple finite element formulation.This work is a continuation of our investigation of the SFWG method for the biharmonic equation.The new SFWG method is highly accurate with a convergence rate of four orders higher than the optimal order of convergence in both the energy norm and the L^(2)norm on triangular grids.This new method also keeps the formulation that is symmetric,positive definite,and stabilizer-free.Four-order superconvergence error estimates are proved for the corresponding SFWG finite element solutions in a discrete H^(2)norm.Superconvergence of four orders in the L^(2)norm is also derived for k≥3,where k is the degree of the approximation polynomial.The postprocessing is proved to lift a P_(k)SFWG solution to a P_(k+4)solution elementwise which converges at the optimal order.Numerical examples are tested to verify the theor ies.

Reversal of the diabetic bone signature with anabolic therapies in mice

The mechanisms underlying the bone disease induced by diabetes are complex and not fully understood;and antiresorptive agents,the current standard of care,do not restore the weakened bone architecture.Herein,we reveal the diabetic bone signature in mice at the tissue,cell,and transcriptome levels and demonstrate that three FDA-approved bone-anabolic agents correct it.Diabetes decreased bone mineral density(BMD)and bone formation,damaged microarchitecture,increased porosity of cortical bone,and compromised bone strength.Teriparatide(PTH),abaloparatide(ABL),and romosozumab/anti-sclerostin antibody(Scl-Ab)all restored BMD and corrected the deteriorated bone architecture.Mechanistically,PTH and more potently ABL induced similar responses at the tissue and gene signature levels,increasing both formation and resorption with positive balance towards bone gain.In contrast,Scl-Ab increased formation but decreased resorption.All agents restored bone architecture,corrected cortical porosity,and improved mechanical properties of diabetic bone;and ABL and Scl-Ab increased toughness,a fracture resistance index.Remarkably,all agents increased bone strength over the healthy controls even in the presence of severe hyperglycemia.These findings demonstrate the therapeutic value of bone anabolic agents to treat diabetes-induced bone disease and suggest the need for revisiting the approaches for the treatment of bone fragility in diabetes.

An Evaluation of Manure Management Strategies, Phosphorus Surface Runoff Potential and Water Usage at an Arkansas Discovery Dairy Farm

Manure management is an essential component of dairy production. Nutrient-laden, field-applied dairy manure often serves as a fertilizer source, but can also pose environmental threats if not properly managed. The Haak dairy farm, located in Decatur, Arkansas, was granted a permit by the Arkansas Department of Environmental Quality (ADEQ) to employ a unique method in treating and storing cattle manure generated during the milking process. This method includes minimizing water use in wash water, dry scraping solids to combine with sawdust for composting and pumping effluent underground into a sloped concrete basin that serves as secondary solid separator before transporting the manure effluent into an interception trench and an adjacent grassed field to facilitate manure nutrient uptake and retention. The Arkansas Discovery Farm program (ADF) is conducting research to evaluate the environmental performance of the dairy’s milk center wash water treatment system (MCWW) by statistical analysis, characterization of phosphorus (P) migration in soil downslope from the inception trench, temperature measurements, and nutrient analysis of a stored dry stack manure/sawdust mixture. Goals included determining possible composting effectiveness along with comparisons to untreated dairy manure and quantifying the use of on-farm water. Results from this research demonstrated that: 1) The MCWW was effective at retaining manure-derived nutrients and reducing field nutrient migration as the MCWW interception trench had significantly higher total nitrogen (TN) (804.2 to 4.1), total phosphorus (TP) (135.6 to 1.5), and water extractable phosphorus (WEP) (55.0 to 1.0) concentrations in milligrams per liter (mg⋅L-1) than the downhill freshwater pond respectively;2) temperature readings of the manure dry stack indicated heightened levels of microbial and thermal activity, but did not reach a standard composting temperature of 54°C;3) manure dry stack nutrient content was typically higher than untreated dairy manure when measured on a “dry basis” in ppm, but was lower on an “as is basis” in ppm and kg/metric ton;and 4) water meter readings showed that the greatest use of on-farm water was for farm-wide cattle drinking (18.77), followed by water used in the milking center (3.45) and then followed by human usage (0.02) measured in cubic meters per day (m3⋅d-1). These results demonstrate that practical innovations in agricultural engineering and environmental science, such as the Haak dairy’s manure treatment system, can effectively reduce environmental hazards that accompany the management of manure at this dairy operation.

Peptic ulcer disease in non-alcoholic fatty liver disease hospitalizations:A new challenge on the horizon in the United States

BACKGROUND Peptic ulcer disease(PUD)is frequently seen in patients with liver cirrhosis.However,current literature lacks data on PUD in non-alcoholic fatty liver disease(NAFLD)hospitalizations.AIM To identify trends and clinical outcomes of PUD in NAFLD hospitalizations in the United States.METHODS The National Inpatient Sample was utilized to identify all adult(≥18 years old)NAFLD hospitalizations with PUD in the United States from 2009-2019.Hospitalization trends and outcomes were highlighted.Furthermore,a control group of adult PUD hospitalizations without NAFLD was also identified for a comparative analysis to assess the influence of NAFLD on PUD.RESULTS The total number of NAFLD hospitalizations with PUD increased from 3745 in 2009 to 3805 in 2019.We noted an increase in the mean age for the study population from 56 years in 2009 to 63 years in 2019(P<0.001).Racial differences were also prevalent as NAFLD hospitalizations with PUD increased for Whites and Hispanics,while a decline was observed for Blacks and Asians.The all-cause inpatient mortality for NAFLD hospitalizations with PUD increased from 2%in 2009 to 5%in 2019(P<0.001).However,rates of Helicobacter pylori(H.pylori)infection and upper endoscopy decreased from 5%in 2009 to 1%in 2019(P<0.001)and from 60%in 2009 to 19%in 2019(P<0.001),respectively.Interestingly,despite a significantly higher comorbidity burden,we observed lower inpatient mortality(2%vs 3%,P=0.0004),mean length of stay(LOS)(11.6 vs 12.1 d,P<0.001),and mean total healthcare cost(THC)($178598 vs$184727,P<0.001)for NAFLD hospitalizations with PUD compared to non-NAFLD PUD hospitalizations.Perforation of the gastrointestinal tract,coagulopathy,alcohol abuse,malnutrition,and fluid and electrolyte disorders were identified to be independent predictors of inpatient mortality for NAFLD hospitalizations with PUD.CONCLUSION Inpatient mortality for NAFLD hospitalizations with PUD increased for the study period.However,there was a significant decline in the rates of H.pylori infection and upper endoscopy for NAFLD hospitalizations with PUD.After a comparative analysis,NAFLD hospitalizations with PUD had lower inpatient mortality,mean LOS,and mean THC compared to the non-NAFLD cohort.

Acute pancreatitis in liver transplant hospitalizations:Identifying national trends,clinical outcomes and healthcare burden in the United States

BACKGROUND Acute pancreatitis(AP)in liver transplant(LT)recipients may lead to poor clinical outcomes and development of severe complications.AIM We aimed to assess national trends,clinical outcomes,and the healthcare burden of LT hospitalizations with AP in the United States(US).METHODS The National Inpatient Sample was utilized to identify all adult(≥18 years old)LT hospitalizations with AP in the US from 2007–2019.Non-LT AP hospitalizations served as controls for comparative analysis.National trends of hospitalization characteristics,clinical outcomes,complications,and healthcare burden for LT hospitalizations with AP were highlighted.Hospitalization characteristics,clinical outcomes,complications,and healthcare burden were also compared between the LT and non-LT cohorts.Furthermore,predictors of inpatient mortality for LT hospitalizations with AP were identified.All P values≤0.05 were considered statistically significant.RESULTS The total number of LT hospitalizations with AP increased from 305 in 2007 to 610 in 2019.There was a rising trend of Hispanic(16.5%in 2007 to 21.1%in 2018,P-trend=0.0009)and Asian(4.3%in 2007 to 7.4%in 2019,p-trend=0.0002)LT hospitalizations with AP,while a decline was noted for Blacks(11%in 2007 to 8.3%in 2019,P-trend=0.0004).Furthermore,LT hospitalizations with AP had an increasing comorbidity burden as the Charlson Comorbidity Index(CCI)score≥3 increased from 41.64%in 2007 to 62.30%in 2019(P-trend<0.0001).We did not find statistically significant trends in inpatient mortality,mean length of stay(LOS),and mean total healthcare charge(THC)for LT hospitalizations with AP despite rising trends of complications such as sepsis,acute kidney failure(AKF),acute respiratory failure(ARF),abdominal abscesses,portal vein thrombosis(PVT),and venous thromboembolism(VTE).Between 2007–2019,6863 LT hospitalizations with AP were compared to 5649980 non-LT AP hospitalizations.LT hospitalizations with AP were slightly older(53.5 vs 52.6 years,P=0.017)and had a higher proportion of patients with CCI≥3(51.5%vs 19.8%,P<0.0001)compared to the non-LT cohort.Additionally,LT hospitalizations with AP had a higher proportion of Whites(67.9%vs 64.6%,P<0.0001)and Asians(4%vs 2.3%,P<0.0001),while the non-LT cohort had a higher proportion of Blacks and Hispanics.Interestingly,LT hospitalizations with AP had lower inpatient mortality(1.37%vs 2.16%,P=0.0479)compared to the non-LT cohort despite having a higher mean age,CCI scores,and complications such as AKF,PVT,VTE,and the need for blood transfusion.However,LT hospitalizations with AP had a higher mean THC($59596 vs$50466,P=0.0429)than the non-LT cohort.CONCLUSION In the US,LT hospitalizations with AP were on the rise,particularly for Hispanics and Asians.However,LT hospitalizations with AP had lower inpatient mortality compared to non-LT AP hospitalizations.

椎茸的乙酸乙脂提取物诱导人乳腺癌MCF-7细胞凋亡的作用

目的观察椎茸的乙酸乙脂提取物对体外培养的人乳腺癌MCF7细胞株诱导凋亡的作用。方法MTT法测定提取物对MCF7细胞生长的影响;AnnexinVFITC和PI染色,采用FCM测定MCF7细胞的凋亡指数;采用FCM分析细胞周期的影响;Westernblot法分析CyclinD1、Cdk4、Bax和p21WAE1/CIP1表达。结果椎茸的乙酸乙脂提取物可以剂量依赖性的抑制乳腺癌细胞株MCF7的生长,使MCF7细胞生长停滞在G0/G1期而诱导MCF7细胞凋亡;通过Bax和p21WAE1/CIP1的表达和降低CyclinD1、Cdk4的表达而诱导MCF7细胞的凋亡。结论椎茸的乙酸乙脂提取物通过诱导细胞凋亡而产生抗乳腺癌的活性。

两性绵霉菌生物量生产的营养需求和发酵条件的研究

对两性绵霉菌(Achlya ambisexualis)生长所需的大量元素和微量元素进行了调查,在PYG培养基础上研制出ZJK培养基.两性绵霉菌在ZJK液体培养基中的倍增时间为3.5小时,产生的生物量约5.5g/L,为PYG的3倍,体积生产率为0.073g/(L·h),为PYG的2倍.最适生长温度为29℃.最适pH为6.5,pH8时孢子萌发被完全抑制.采用pH6.5控制的生物量培养,碳素和氮素转化率明显提高,分别为47.1%和64.8%,体积生产率比非pH控制的分批培养提高50%.在20L发酵罐中,生长稳定期的氧摄取速率为7.0-8.8mol/(L·h).采用分批补料发酵法,生物量达到15g/L.

白藜芦醇对造血系统辐射损伤的防护作用

背景：骨髓抑制是辐射损伤的主要表现，也是临床进行肿瘤放疗时最常见的副作用。骨髓幼稚型造血细胞（hematopoietic progenitor cells, HPCs）（对缺血应激产生快速增殖反应，受到辐射损伤后引起急性骨髓抑制；

大数据时代首席数据官的角色与职责

随着大数据时代的到来,首席数据官(CDO)承担起了管理各类数据的工作,但作为一个新兴的职位,CDO在组织中扮演的角色和承担的职责尚不完全清晰。本文运用两阶段调研法,以美国多家企业的CDO为主要调研对象,结合他们的实际工作,梳理CDO承担的主要工作职责,归纳其在企业运行中扮演的角色,建立CDO角色和职责的层次结构。研究表明,CDO在企业中主要承担最大化商业价值、挖掘新的商业机会、数据质量管理等28项工作职责;主要扮演5种角色:数据管理者、商业价值挖掘者、决策制定者、协调者、数据概念及技能推广者。通过角色和职责权重分析得出,CDO最重要的角色是数据管理者和商业价值挖掘者,最重要的职责是最大化数据价值和挖掘新的商业机会。