High Ratio Group Research Articles

Platelet to erythrocyte ratio and mortality in massively transfused trauma patients.

BackgroundThe optimal transfusion ratio of platelets (PLT), plasma and red blood cells (RBC) in trauma patients with massive haemorrhage is still a subject of discussion. The objective of this study is to assess the effect of platelet transfusion on mortality in trauma patients who received massive transfusion. MethodsData were collected from four Dutch level-1 trauma centres. All trauma patients aged ≥ 16 years who received ≥ 6 RBC / 6 hours from the time of injury were included. Patients were divided based on PLT:RBC ratio (no platelets, low (<1:5) and high (≥1:5)). Primary outcome measure was 6-hour mortality and secondary outcomes included mortality at other time points and transfusion characteristics. ResultsA total of 292 patients were included. Patients in the high PLT ratio group had lower mortality rates at six and 12 hours as compared to the low PLT ratio and no PLT group. In the high PLT group mortality as a result of exsanguination (12%) was significantly lower as compared to the low PLT group (23%). High PLT ratio had lower probability for 6-hour mortality multivariable analysis. Higher plasma:RBC ratios were associated with lower mortality at all time points. ConclusionsAlthough the optimal patient specific transfusion strategy in patients with traumatic haemorrhage is still not resolved, these results show that higher PLT to RBC ratios are associated with lower early mortality.

The red blood cell distribution width to albumin ratio was a potential prognostic biomarker for acute respiratory failure: a retrospective study

BackgroundThe association between red blood cell distribution width (RDW) to albumin ratio (RAR) and prognosis in patients with acute respiratory failure (ARF) admitted to the Intensive Care Unit (ICU) remains unclear. This retrospective cohort study aims to investigate this association.MethodsClinical information of ARF patients was collected from the Medical Information Mart for Intensive Care IV (MIMIC-IV) version 2.0 database. The primary outcome was, in-hospital mortality and secondary outcomes included 28-day mortality, 60-day mortality, length of hospital stay, and length of ICU stay. Cox regression models and subgroup analyses were conducted to explore the relationship between RAR and mortality.ResultsA total of 4547 patients with acute respiratory failure were enrolled, with 2277 in the low ratio group (RAR < 4.83) and 2270 in the high ratio group (RAR > = 4.83). Kaplan-Meier survival analysis demonstrated a significant difference in survival probability between the two groups. After adjusting for confounding factors, the Cox regression analysis showed that the high RAR ratio had a higher hazard ratio (HR) for in-hospital mortality (HR 1.22, 95% CI 1.07–1.40; P = 0.003), as well as for 28-day mortality and 60-day mortality. Propensity score-matched (PSM) analysis further supported the finding that high RAR was an independent risk factor for ARF.ConclusionThis study reveals that RAR is an independent risk factor for poor clinical prognosis in patients with ARF admitted to the ICU. Higher RAR levels were associated with increased in-hospital, 28-day and 60-day mortality rates.

Impact of Shunt/Pulmonary Artery Ratio on Outcomes in Modified Blalock-Taussig Shunt Patients

Background: The modified Blalock-Taussig shunt (mBTT shunt) is a critical procedure for managing congenital heart defects by improving pulmonary circulation. Traditionally, shunt size is determined based on patient weight and standard guidelines. However, recent evidence indicates that the shunt size relative to the pulmonary artery diameter (S/PA ratio) may be a more accurate predictor of outcomes. This study evaluates the impact of the S/PA ratio on mortality and other clinical outcomes in patients undergoing the mBTT shunt. Methods: This retrospective study analyzed the medical records of 36 patients who underwent mBTT shunt at Soetomo General Academic Hospital between 2021 and 2023. Data on demographics, clinical characteristics, procedural details, and outcomes were collected, focusing on variables such as age, weight, McGoon ratio, pre- and post-operative SpO2 levels, and S/PA ratio. Statistical analyses included Chi-square tests for categorical variables and independent t-tests for continuous variables, with a p-value of &lt;0.05 considered significant. Results: The cohort had a mean age of 54.81 months and a mean weight of 12.18 kg. Preoperative SpO2 averaged 71.44%, improving to 79.26% post-operatively. Patients with an S/PA ratio &gt;1.00 had a significantly higher mortality rate (37.5%) compared to those with an S/PA ratio &lt;1.00 (7.7%) (p = 0.029). These patients also experienced longer ICU stays (4.92 vs. 2.06 days, p = 0.005) and more ventilation days (3.40 vs. 1.68 days, p = 0.047). The hospital stay was also extended in the higher ratio group (8.60 vs. 5.50 days, p = 0.076). No significant differences were observed in pre- and post-operative SpO2 levels or inotropic use. Conclusion: A higher S/PA ratio is associated with increased mortality, longer ICU and hospital stays, and greater ventilation needs following the mBTT shunt. These findings suggest that optimizing shunt size relative to pulmonary artery diameter could lead to better outcomes. Further research is needed to confirm these results and refine surgical strategies for enhanced patient care.

FINDING THE SWEET SPOT: THE ASSOCIATION BETWEEN WHOLE BLOOD TO RED BLOOD CELLS RATIO AND OUTCOMES OF HEMORRHAGING CIVILIAN TRAUMA PATIENTS.

Purpose: To evaluate the dose-dependent effect of whole blood (WB) on the outcomes of civilian trauma patients with hemorrhagic shock. Methods: We performed a 2-year (2020-2021) retrospective analysis of the ACS-TQIP dataset. Adult (≥18) trauma patients with a shock index (SI) >1 who received at least 5 units of PRBC and one unit of WB within the first 4 h of admission were included. Primary outcomes were 6-h, 24-h, and in-hospital mortality. Secondary outcomes were major complications and hospital and intensive care unit length of stay. Results: A total of 830 trauma patients with a mean (SD) age of 38 (16) were identified. The median [IQR] 4-h WB and PRBC requirements were 2 [2-4] U and 10 [7-15] U, respectively, with a median WB:RBC ratio of 0.2 [0.1-0.3]. Every 0.1 increase in WB:RBC ratio was associated with decreased odds of 24-h mortality (aOR: 0.916, P = 0.035) and in-hospital mortality (aOR: 0.878, P < 0.001). Youden's index identified 0.25 (1 U of WB for every 4 U of PRBC) as the optimal WB:PRBC ratio to reduce 24-h mortality. High ratio (≥0.25) group had lower adjusted odds of 24-h mortality (aOR: 0.678, P = 0.021) and in-hospital mortality (aOR: 0.618, P < 0.001) compared to the low ratio group. Conclusions: A higher WB:PRBC ratio was associated with improved early and late mortality in trauma patients with hemorrhagic shock. Given the availability of WB in trauma centers across the United States, at least one unit of WB for every 4 units of packed red blood cells may be administered to improve the survival of hemorrhaging civilian trauma patients.

Prognostic value of perioperative changes in the prognostic nutritional index in patients with surgically resected non-small cell lung cancer

PurposeThis single-institution retrospective cohort study was conducted to assess the prognostic significance of perioperative changes in the prognostic nutritional index (PNI) in patients who underwent surgery for non-small cell lung cancer (NSCLC).MethodsClinicopathological data were collected from 441 patients who underwent lobectomy for NSCLC between 2010 and 2016.The PNI ratio (postoperative PNI/preoperative PNI) was used as an indicator of perioperative PNI changes. Prognostic differences were investigated based on PNI ratios.ResultsThe optimal cut-off value of the PNI ratio for overall survival (OS) was set at 0.88 using a receiver operating characteristic curve. The PNI ratio was inversely related to a high smoking index, interstitial lung disease, and postoperative pulmonary complications. The 5-year OS rates for the high vs. low PNI ratio groups were 88.2% vs. 68.5%, respectively (hazard ratio [HR]: 3.04, 95% confidence interval [CI]: 1.90–4.86). Multivariable analysis revealed that a low PNI ratio was significantly associated with poor prognosis (HR: 2.94, 95% CI: 1.77–4.87). The PNI ratio was a more sensitive indicator than postoperative PNI status alone for identifying patients at high risk of mortality, particularly those with non-lung cancer causes.ConclusionThe perioperative PNI change is a significant prognostic factor for patients with NSCLC.

Is digit ratio (2D:4D) a biomarker for lactate? Evidence from a cardiopulmonary test on professional male footballers

BackgroundLactate accumulation is associated with vigorous exercise, cardiovascular disease and a number of cancers. Digit ratio (2D:4D) has also been linked to oxygen metabolism, myocardial infarction and various cancers. Such similarities suggest the possibility that 2D:4D is a biomarker of lactate. Here, we consider the relationship between 2D:4D and lactate during an incremental cardiopulmonary exercise test. MethodThe participants were male professional football players. The treadmill test began at a speed of 8 km/h when the first lactate measurement was taken. The speed was increased by 2 km/h every 3.15 min, with measurements at 10, 12, 14 and 16 km/h. ResultsThere were 72 Caucasian and 7 Black participants, results are reported for the most numerous group. Lactate levels increased with running speed and were not correlated with age, body size or body composition. Median splits of digit ratios (right, left and right-left 2D:4D [Dr-l]) were calculated. In comparison to the Low ratio group, the High ratio group showed higher lactate levels across speeds. Effect sizes varied from very large to huge (right 2D:4D), large (left 2D:4D) and medium (Dr-l). At the individual level, positive correlations between digit ratios and lactate at the five different speeds varied from large (right 2D:4D), medium (left 2D:4D) and small (Dr-l). ConclusionThere were large positive associations between right 2D:4D and lactate at all running speeds. We discuss our findings in relation to oxygen metabolism and suggest that 2D:4D may be a biomarker for lactate in the wider context of the latter's importance in health and disease.

Abstract 3807: CXCL9:SPP1 macrophage polarity as a prognostic biomarker for localized colorectal cancer after surgical resection

Abstract Background: There is an unmet need for additive predictive biomarkers for the recurrence of stage II/III colorectal cancer (CRC) after surgery. As recent studies showing the potential prognostic role of macrophage polarity defined by CXCL9 and SPP1, instead of conventional M1 and M2, we tried to evaluate the prognostic role of this biomarker in real-world practice setting, delineating biologic mechanisms. Method: The RNA sequencing data of 273 tumors derived from patietns with stage II/III colorectal cancer who underwent surgical resection in 5 Korean cancer-centers were available for analysis. We initially divided two subgroups based on the ratio of expression level of CXCL9 per SPP1 expressions (CS ratio) and evaluated prognostic outcomes and compared immune cell proportions by deconvolutional method between subgroups. Result: The CS ratio was higher in consensus molecular subtype (CMS)2 or CMS3 than others, and no significant differences were observed according to sidedness, stage, microsatellite instability status and medical centers. Total 69 (25,3%) patients were classified as low level of CS ratio group, and there were no significant differences in baseline characteristics, including age, sex, CMS, sidedness, stage, microsatellite instability status and medical centers. With a median follow-up of 58.2 months, the low CS ratio group showed poor 5-year recurrence-free survival (50.6 vs. 71.1%, HR=2.27, P = 0.002) and 5-year overall survival (69.7% vs. 85.9%, HR=1.75, P = 0.033). These trends were consistent across the subgroups. In the multivariate analyses including the potential prognostic factors (P &amp;lt; 0.1 in the univariate analyses), low CS ratio was significantly associated with poorer for RFS (adjusted HR = 1.96, P = 0.011) and OS (adjusted HR = 1.81, P = 0.002). These trends were consistent in the TCGA dataset (5 years OS: 69.7% vs. 85.9%, HR=1.98, P = 0.011). The low CS ratio group showed upregulated WNT signaling, and extracellular matrix organization pathway. Immune cell deconvolutional method exhibited the low CS ratio group showed more proportion of neutrophils, monocytes, whereas CD8+T cells, activated memory CD4+T cells were decreased, compared to high CS ratio group. Conclusions: These results suggest that CS ratio could be an applicable prognostic biomarker in locally advanced colorectal cancer after surgical resection. Based on this classification, more advanced treatment strategy may be required for low CS ratio group to improve surgical outcomes. Citation Format: Yeong Hak Bang, Ji Hye Choi, Hyunsu Kim, Kyunghee Park, Dae Hee Pyo, Yong Beom Cho, Woong-Yang Park. CXCL9:SPP1 macrophage polarity as a prognostic biomarker for localized colorectal cancer after surgical resection [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3807.

Effect of early peri-operative arterial lactate concentration level ratios on post-hepatectomy liver failure

BackgroundPost-hepatectomy liver failure (PHLF) is a serious complication after hepatectomy and a major cause of death. The current criteria for PHLF diagnosis (ISGLS consensus) require laboratory data of elevated INR level and hyperbilirubinemia on or after postoperative day 5. This study aims to propose a new indicator for the early clinical prediction of PHLF.MethodsThe peri-operative arterial lactate concentration level ratios were derived from time points within the 3 days before surgery and within POD1, the patients were divided into two groups: high lactate ratio group (≥ 1) and low lactate ratio group (< 1). We compared the differences in morbidity rates between the two groups. Utilized logistic regression analysis to identify the risk factors associated with PHLF development and ROC curves to compare the predictive value of lactate ratio and other liver function indicators for PHLF.ResultsA total of 203 patients were enrolled in the study. Overall morbidity and severe morbidity occurred in 64.5 and 12.8 per cent of patients respectively. 39 patients (19.2%) met the criteria for PHLF, including 15 patients (7.4%) with clinically relevant Post-hepatectomy liver failure (CR-PHLF). With a significantly higher incidence of PHLF observed in the lactate ratio ≥ 1 group compared to the lactate ratio < 1 group (n = 34, 26.8% vs. n = 5, 6.6%, P < 0.001). Multivariable logistic regression analysis revealed that a lactate ratio ≥ 1 was an independent predictor for PHLF (OR: 3.239, 95% CI 1.097–9.565, P = 0.033). Additionally, lactate ratio demonstrated good predictive efficacy for PHLF (AUC = 0.792).ConclusionsEarly assessment of peri-operative arterial lactate concentration level ratios may provide experience in early intervention of complications in patients with hepatocellular carcinoma, which can reduce the likelihood of PHLF occurrence and improve patient prognosis.

Study on the lignin-derived sp2–sp3 hybrid hard carbon materials and the feasibility for industrial production

Hard carbon has been widely used in anode of lithium/sodium ion battery, electrode of supercapacitor, and carbon molecular sieve for CO2 capture and hydrogen storage. In this study the lignin derived hard carbon products are investigated, and the conclusions are abstracted as follows. (1) The lignin derived hard carbon products consist of microcrystal units of sp2 graphene fragments, jointed by sp3 carbon atoms and forming sp2–sp3 hybrid hard carbon family. (2) From the lignin precursors to the sp2–sp3 hybrid hard carbon products, most carbon atoms retain their original electron configurations (sp2 or sp3) and keep their composition in lignin. (3) The architectures of lignin-derived hard carbon materials are closely dependent on the forms of their lignin precursors, and could be preformed by different pretreatment techniques. (4) The carbonization of lignin precursors follows the mechanism “carbonization in situ and recombination nearby”. (5) Due to the high carbon ratio and abundant active functional groups in lignin, new activation techniques could be developed for control of pore size and pore volume. In general lignin is an excellent raw material for sp2–sp3 hybrid hard carbon products, a green and sustainable alternative resource for phenolic resin, and industrial production for lignin derived hard carbon products would be feasible.

The correlation between the neutrophil-to-lymphocyte ratio and random blood glucose in patients with type 2 diabetes mellitus in Prof. Dr. I G. N. G. Ngoerah Hospital

Background: Diabetes mellitus and complications related to this disease have become a great problem affecting one in eleven adults. Pathophysiologically, this disease occurs due to impaired insulin secretion, resulting from systemic dysfunction in metabolic homeostasis involving inflammatory processes. One marker that can be used to measure such chronic inflammation is the neutrophil-lymphocyte ratio. Therefore, this study aims to evaluate the association between the neutrophil-to-lymphocyte ratio (NLR) with random blood glucose in patients with type 2 diabetes mellitus in Prof. Dr. I G. N. G. Ngoerah Hospital Methods: Our study is a cross-sectional study with secondary data from medical records and involved 155 type 2 diabetes mellitus patients who received inpatient or outpatient care at Prof. Dr. I G. N. G. Ngoerah Hospital in the period of 2021-2022. Results: Our analysis found a significant correlation between the neutrophil-lymphocyte ratio with random blood sugar levels (r = 0.228; p = 0.004). Additionally, the analysis also found a significant difference in random blood sugar level between the normal with the high neutrophil-lymphocyte ratio groups (p = 0.023; median difference = 39.5 mg/dL). Conclusion: It can be inferred that there is a weak and significant correlation between NLR with random blood glucose level in type 2 diabetes mellitus patients.

Protamine dosing and its impact in cardiac surgery transfusion practice-A retrospective bi-institutional analysis.

Bleeding after cardiac surgery is common and continues to require 10-20% of the national blood supply. Transfusion of allogeneic blood is associated with increased morbidity and mortality. Excessive protamine in the absence of circulating heparin after weaning off CPB can cause anticoagulation and precipitate bleeding. Hence, adequate dose calculation of protamine is crucial yet under evaluated. Retrospective cohort study. We conducted a retrospective bi-institutional analysis of cardiac surgical patients who underwent cardiopulmonary bypass (CPB)-assisted cardiac surgery to assess the impact of protamine dosing in transfusion practice. Total 762 patients were identified from two institutions using electronic medical records and the Society of Thoracic Surgery (STS) database who underwent cardiac surgery using CPB. Patients were similar in demographics and other baseline characteristics. We divided patients into two groups based on mg of protamine administered to neutralize each 100 U of unfractionated heparin (UFH)-low-ratio group (Protamine: UFH ≤ 0.8) and high-ratio group (Protamine: UFH > 0.8). We observed a higher rate of blood transfusion required in high-ratio group (ratio >0.8) compared with low-ratio group (ratio ≤0.8) (p < .001). The increased requirement was consistently demonstrated for intraoperative transfusions of red blood cells, plasma, platelets, and cryoprecipitate. High protamine to heparin ratio may cause increased bleeding and transfusion in cardiac surgical patients. Protamine to heparin ratio of 0.8 or lower is sufficient to neutralize circulating heparin after weaning off cardiopulmonary bypass.

Incorporation of cellulose nanocrystals to improve the physicochemical and bioactive properties of pectin-konjac glucomannan composite films containing clove essential oil

This study aimed to investigate the effectiveness of cellulose nanocrystals (CNC) isolated from cotton in augmenting pectin (PEC)/konjac glucomannan (KGM) composite films containing clove essential oil (CEO) for food packaging application. The effects of CNC dosage on film properties were examined by analyzing the rheology of film-forming solutions and the mechanical, barrier, antimicrobial, and CEO-release properties of the films. Rheological and FTIR analysis revealed the enhanced interactions among the film components after CNC incorporation due to its high aspect ratio and abundant hydroxyl groups, which can also prevent CEO droplet aggregation, contributing to form a compact microstructure as confirmed by SEM and 3D surface topography observations. Consequently, the addition of CNC reinforced the polysaccharide matrix, increasing the tensile strength of the films and improving their barrier properties to water vapor. More importantly, antibacterial, controlled release and kinetic simulation experiments proved that the addition of CNC could further slow down the release rate of CEO, prolonging the antimicrobial properties of the films. PEC/KGM/CEO composite films with 15 wt% CNC was found to have relatively best comprehensive properties, which was also most effective in delaying deterioration of grape quality during the storage of 9 days at 25 °C.

Association Analysis Between Maternal Neutrophil Ratio and the Risk of Histological Chorioamnionitis in Pregnant Women with Premature Rupture of Membranes in Late Pregnancy.

We aimed to investigate the association between maternal neutrophil ratio and histological chorioamnionitis (HCA) risk in pregnant women with premature rupture of membranes (PROM) in late pregnancy. A retrospective analysis was conducted on 95 cases of women with PROM in their late pregnancy between March 2018 and August 2021. These women were divided into two groups based on the presence of HCA. General clinical data and laboratory indicators were compared between the two groups. A generalized additive model was used for curve fitting, and a segmented regression model was used to explain further the non-linear relationship between neutrophil ratio and HCA risk. After adjusting for confounding factors, the curve fitting showed a "U"-shaped curve relationship between the neutrophil ratio and the risk of HCA. When the neutrophil ratio was <76.3%, the risk of HCA exhibited a decreasing trend, but the difference was not statistically significant (adjusted OR = 0.884, 95% CI: 0.781-1.001, P = 0.053). However, when the neutrophil ratio was >76.3%, the HCA risk was significantly increased (adjusted OR = 1.339, 95% CI: 1.067-1.680, P = 0.012). Furthermore, we equally divided the neutrophil ratio into three groups. The risk of HCA was significantly increased in the low-ratio group (OR = 4.292, 95% CI: 1.247-14.706, P = 0.021) compared with the middle-ratio group, which was used as the reference group. Similarly, the HCA risk of the high-ratio group (OR = 13.145, 95% CI: 1.796-96.233, P = 0.011) was also significantly enhanced. However, there was no significant difference in HCA risk between the high-ratio and low-ratio groups (OR = 1.182, 95% CI: 0.357-3.909, P = 0.784). There was a significant "U"-shaped relationship between maternal neutrophil ratio and HCA risk in women with PROM in late pregnancy.

Association between white blood cell-to-haemoglobin ratio and 30day mortality in heart failure in intensive care unit.

The short-term mortality of heart failure (HF) patients admitted to the intensive care unit (ICU) is reported to be high. This study aims to explore the association between white blood cell-to-haemoglobin ratio (WHR) and 30day mortality from the admission to the ICU. This retrospective cohort study was performed based on the Medical Information Mart for Intensive Care III (MIMIC-III) database (2001-12) and MIMIC-IV database (2008-19). Covariables were selected using the least absolute shrinkage and selection operator regression. Based on the optimal cutoff point selected using the survminer package, WHR was divided into high-ratio group (≥1.6) and low-ratio group (<1.6). The association between WHR and the risk of 30day mortality was explored using univariate and multivariable Cox regression models. The area under the receiver operating characteristic curve (AUC) was calculated to evaluate the prediction performance of WHR. A total of 13702 patients were included. After adjusting the potential covariates, high WHR was associated with a greater risk of 30day mortality compared with low WHR [hazard ratio=1.16, 95% confidence interval (CI): 1.07-1.27, P<0.001]. WHR also showed a good performance for the prediction of risk of 30day mortality (AUC=0.751, 95% CI: 0.746-0.756). WHR was positively associated with and performed well to predict 30day mortality, indicating that WHR may be a reliable index to assess the prognosis of HF patients admitted to the ICU.

Association between statin compliance and risk of dementia among patients with chronic periodontitis.

We investigated the association between statin compliance and the risk of dementia among patients with chronic periodontitis. Chronic periodontitis patients were extracted from the National Health Insurance Service-Health Screening Cohort Database, covering the period from 2002 to 2019. A total of 22,089 subjects were included in the study and divided into three groups based on their compliance with statin administration. The Cox proportional hazard model was utilized to calculate hazard ratios and 95% confidence intervals for analyzing the risk of dementia. In the restricted cubic spline of the multivariable-adjusted model, the hazard ratio for dementia decreased prominently with a higher medication possession ratio. The hazard ratios and 95% confidence intervals in the multivariable-adjusted model for dementia risk in the middle and high medication possession ratio groups, compared to the low medication possession ratio group, were confirmed as 0.70 (0.57-0.87) and 0.57 (0.45-0.72), respectively. In the subgroup analysis, a significant association between dementia and good statin medication possession ratio was found in both severe periodontitis and mild periodontitis cases. Our findings suggest that a group of patients with chronic periodontitis who maintain good statin compliance are associated with a reduced risk of dementia.

Efficacy of autologous dermal sheath cup cell transplantation in male and female pattern hair loss: A Single-Arm, Multi-Center, phase III equivalent clinical study.

A previous, proof-of-concept clinical study suggested that dermal sheath cup cell injections into the affected areas of male/female pattern hair loss (PHL) may have some amelioratory effects, the clinical efficacy of which needs further examination. A phase III equivalent clinical study was conducted to further probe the therapeutic potential of this novel approach and verify its safety and efficacy in improving the appearance of PHL. Thirty-six participants with PHL were injected with dermal sheath cup cell harvested from non-affected occipital hair follicles twice in quarterly intervals. Global photographic assessment and phototrichogram were performed in a blinded manner. Patient-reported outcomes were assessed for 12 months. On global photographic assessment, 30% of the participants showed improvement. The analysis of phototricogram data detected the increases in the cumulative hair diameter, hair cross-sectional area, and mean hair diameter of 107.6 ± 152.6 μm/cm2 , 13069.1 ± 10960.7 μm2 /cm2 , and 0.9 ± 0.9 μm (ratios vs. baseline: +1.4%, +3.4%, and +2.2%), respectively. The female and high terminal hair ratio groups achieved better improvement. Of the total participants, 62.9% noted some degree of improvement. No serious adverse events were detected. This novel approach exhibited visible effects while ensuring safety and patient satisfaction. Therefore, it holds promise as a possible therapeutic option for treating PHL, especially in women.

Efficient CO2 separation by ionic liquid nanoconfined in ultra-thin TCOH@Pebax-1657 MMM

Global climate change has continued to intensify in recent years, and the low efficiency of carbon emission reduction has become an important issue for many countries. Membrane separation technology has gained popularity in CO2 capture due to its ease of operation, environmental friendliness, and smaller area, etc. Two-dimensional (2D) sheet materials are one of the most promising materials for membrane separation technology. MXene has been used for gas separation because of its advantages such as high aspect ratio, excellent flexibility, and rich functional group surface. However, the stacking of massive MXene nanosheets lead to gas transport channel obstruction, causing the gas permeance to decrease. Herein, the hydroxylation of MXene was treated to obtain alkaline MXene nanosheets (TCOH) in this work. The stabilised TCOH and Pebax-1657 were used to make a mixed matrix membrane (MMM), while 1-ethyl-3-methylimidazolyl acetate ([EMIm][AcO], IL) was nanoconfined in the 2D channel of ultra-thin TCOH@Pebax-1657 MMM to construct a novel composite membrane for efficient CO2 capture. The TCOH@Pebax-1657/IL membrane prepared in this experiment has high CO2 permeance and the selectivity of CO2/N2, CO2/CH4 at the IL concentration of 35 wt%. In addition, the film has shown excellent thermal stability and durability over long periods of testing. Since TCOH is rarely used in the field of gas separation, the study will provide fresh idea for the preparation of highly efficient CO2 capture membranes.

Cellulose nanocrystal addition in thin film nanocomposite membranes: Which monomer solution is preferred?

AbstractCellulose nanocrystals (CNCs) are biodegradable nanoparticles with a high aspect ratio and abundant surface hydroxyl groups resulting in negatively charged hydrophilic surfaces that make them an ideal candidate to be incorporated in thin‐film nanocomposite (TFN) membranes. In this study, we modified the CNCs via acetylation (ACNCs) to reduce their hydrophilicity and via reaction with L‐cysteine (CysCNCs) to impart them with functionality that promoted their interaction with the trimesoyl chloride organic monomer used in the preparation of the poly(amide) layer of the TFN membranes. These modifications allowed us to question in which monomer solution the nanoparticles should be dispersed. Addition of the unmodified CNCs in either the aqueous or organic monomer solution showed little difference in membrane performance. However, the addition of either the ACNCs or the CysCNCs to the organic monomer solution led to a significant increase in membrane performance in reverse osmosis (RO) and nanofiltration (NF) systems compared to their addition to the aqueous monomer solution. In addition, the CysCNCs exhibited performance very near the upper‐bound line for RO and NF.

The ratio of QRS/RV6-V1: a new electrocardiographic predictor of short- and long-term adverse clinical outcomes in patients with acute myocardial infarction combined with new-onset right bundle branch block.

A few studies have focused on electrocardiography (ECG) parameters correlating with clinical prognosis in patients with acute myocardial infarction (AMI) combined with new-onset right bundle branch block (RBBB). To assess the prognostic value of a new ECG parameter, namely, the ratio of QRS duration/RV6-V1 interval (QRS/RV6-V1), in patients with AMI combined with new-onset RBBB. A total of 272 AMI patients combined with new-onset RBBB who received primary percutaneous coronary intervention (P-PCI) were retrospectively enrolled in the study. First, the patients were divided into survival group and non-survival group. Demographic, angiographic, and ECG characteristics were compared between the two groups. Receiver operating characteristic (ROC) curve was used to screen the best ECG parameter for predicting 1-year mortality. Second, the ratio of QRS/RV6-V1, a continuous variable, was converted to the high ratio group and low ratio group according to the optimal cutoff value point determined by the X-tile software. We compared the patient's demographic, angiographic, and ECG characteristics, in-hospital major adverse cardiovascular events (MACE), and 1-year mortality between the two groups. Multivariate logistic and Cox regressions were used to evaluate whether the ratio of QRS/RV6-V1 was an independent prognostic factor of in-hospital MACE and 1-year mortality. The ROC curve showed that the ratio of QRS/RV6-V1 had a higher value for predicting in-hospital MACE and 1-year mortality than the QRS duration, RV6-V1 interval, and RV1 interval. The patients in the high ratio group had significantly higher CK-MB peak and Killip class, lower ejection fraction (EF%), higher ratio of the left anterior (LAD) descending artery as infarct-related artery (IRA), and longer total ischemia time (TIT) than those in the low ratio group. The QRS duration was wider in the high ratio group than that in the low ratio group, whereas RV6-V1 was narrower in the high ratio group compared with that in the low ratio group. The in-hospital MACE rate (93.3% vs. 31.0%, p < 0.001) and 1-year mortality rate (86.7% vs. 13.2%, p < 0.001) in the high ratio group were higher than those in the low ratio group. The higher ratio of QRS/RV6-V1 was an independent predictor of in-hospital MACE (odds ratio, 8.55; 95% CI, 1.40-52.37; p = 0.02) after adjusting other confounders. Cox regression showed that the higher ratio of QRS/RV6-V1 predicted higher 1-year mortality of the patients with AMI combined with new-onset RBBB [hazard ratios (HR), 12.4; 95% CI, 7.26-21.22); p < 0.001] than the lower ratio of QRS/RV6-V1, and the HR still stayed at 2.21 even after a multivariable adjustment (HR, 2.21; 95% CI, 1.05-4.64); p = 0.037). According to the results of our study, the high ratio of QRS/RV6-V1 (>3.0) was a valuable predictor of short- and long-term adverse clinical outcomes in AMI patients combined with new-onset RBBB. The implications of the high ratio of QRS/RV6-V1 were severe ischemia and pseudo synchronization between bi-ventricle.

Association of blood product ratios with early mortality in pediatric trauma resuscitation: A time-dependent analysis from the National Trauma Databank.

Injured children with severe hemorrhage often receive blood product transfusions with ratios of plasma and platelets to packed red blood cells (PRBCs) approaching 1:1:1. Whether blood product ratios vary during pediatric resuscitation is unknown. This study (1) described precise timing of pediatric blood product administration, (2) characterized changes in blood product ratios over time, and (3) evaluated the association of blood products with early mortality while incorporating time-varying factors. Pediatric (younger than 18 years) trauma patients receiving high-volume transfusion (>40 mL/kg total products or >2 U PRBC or whole blood, during first 4 hours) were obtained from the 2017 to 2019 Trauma Quality Improvement Program database. The time of each individual product transfusion was recorded, along with demographics, injury details, and times of death. Patients were assigned to blood product groups at 15-minute intervals: high plasma/PRBC ratio (>1:1) with platelets, high plasma/PRBC ratio (>1:1) without platelets, low plasma/PRBC ratio (<1:1), PRBC only, and whole blood. Cox proportional hazards modeling for 24-hour mortality was performed, including blood product group as a time-varying variable and adjusting for relevant covariates. Of 1,152 included patients (median age, 15 years; 32% penetrating, 28% severe traumatic brain injury [sTBI]), 18% died within 24 hours. During the resuscitation period, the number of patients in high-ratio groups increased over time, and patients switched blood product groups up to six times. There was no significant difference in mortality by blood product group. Among patients with sTBI, there was a strong trend toward lower mortality among high plasma/PRBC without platelets versus high plasma/PRBC with platelets (hazard ratio, 0.55; p = 0.07). No significant association of high ratios or whole blood with mortality was seen when time-varying factors were incorporated. The impact of balanced resuscitation strategies, particularly platelet transfusion, may be greatest among patients with sTBI. Optimizing balanced resuscitation for children requires appropriately designed prospective studies. Therapeutic/Care Management; Level IV.