Modified Technique of Pancreaticogastrostomy for Soft Pancreas with Two Continuous Hemstitch Sutures: A Single-Center Prospective Study

Postoperative pancreatic fistula (POPF) remains a persistent problem after pancreaticoduodenectomy (PD), especially in the presence of a soft, nonfibrotic pancreas. To reduce the risk of POPF, pancreaticogastrostomy (PG) is an optional reconstruction technique for surgeons after PD. This study presents a new technique of PG for a soft, nonfibrotic pancreas with double-binding continuous hemstitch sutures and evaluates its safety and reliability. From January 2011 to June 2012, 92 cases of patients with periampullary malignancy with a soft pancreas underwent this technique. A modified technique of PG was performed with two continuous hemstitch sutures placed in the mucosal and seromuscular layers of the posterior gastric wall, respectively. Then the morbidity and mortality was calculated. This technique was applied in 92 patients after PD all with soft pancreas. The median time for the anastomosis was 12 min (range, 8–24). Operative mortality was zero, and morbidity was 16.3 % (n = 15), including hemorrhage (n = 2), biliary fistula (n = 2), pulmonary infection (n = 1), delayed gastric emptying (DGE; n = 5, 5.4 %), abdominal abscess (n = 3, one caused by PF), and POPF (n = 2, 2.2 %). Two patients developed a pancreatic fistula (one type A and one type B) classified according to the International Study Group on Pancreatic Fistula. The described technique is a simple and safe reconstruction procedure after PD, especially for patients with a soft and fragile pancreas. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s11605-013-2183-8) contains supplementary material, which is available to authorized users

Response of bacterial community metabolites to bacterial wilt caused by Ralstonia solanacearum: a multi-omics analysis

The soil microbial community plays a critical role in promoting robust plant growth and serves as an effective defence mechanism against root pathogens. Current research has focused on unravelling the compositions and functions of diverse microbial taxa in plant rhizospheres invaded by Ralstonia solanacearum, however, the specific mechanisms by which key microbial groups with distinct functions exert their effects remain unclear. In this study, we employed a combination of amplicon sequencing and metabolomics analysis to investigate the principal metabolic mechanisms of key microbial taxa in plant rhizosphere soil. Compared to the healthy tobacco rhizosphere samples, the bacterial diversity and co-occurrence network of the diseased tobacco rhizosphere soil were significantly reduced. Notably, certain genera, including Gaiella, Rhodoplanes, and MND1 (Nitrosomonadaceae), were found to be significantly more abundant in the rhizosphere of healthy plants than in that of diseased plants. Eight environmental factors, including exchangeable magnesium, available phosphorus, and pH, were found to be crucial factors influencing the composition of the microbial community. Ralstonia displayed negative correlations with pH, exchangeable magnesium, and cation exchange flux, but showed a positive correlation with available iron. Furthermore, metabolomic analysis revealed that the metabolic pathways related to the synthesis of various antibacterial compounds were significantly enriched in the healthy group. The correlation analysis results indicate that the bacterial genera Polycyclovorans, Lysobacter, Pseudomonas, and Nitrosospira may participate in the synthesis of antibacterial compounds. Collectively, our findings contribute to a more in-depth understanding of disease resistance mechanisms within healthy microbial communities and provide a theoretical foundation for the development of targeted strategies using beneficial microorganisms to suppress disease occurrence

Continuous Temporal Signals and Electronic Health Records for Broad Health States Forecasting

The modern medical data deluge accelerated when the vast amount of medical information gathered and stored by electronic sensors became widely available. Medical data are complex, heterogeneous, and continue to rapidly accumulate in electronic databases, therefore, data-driven statistical learning techniques have the potential to drastically improve clinical care by anticipating clinical complications and suggesting interventions.This dissertation investigates the application of an assortment of statistical learning techniques to extract instructive patterns from raw medical data. Chapter 1 provides a brief overview of current statistical learning methods. We also examine both the limitations and the opportunities for state-of-the-art developments in medical forecasting. Chapter 2 introduces a project that began as a mere conjecture formulated by an endocrinologist but developed into a large-data analysis of linked pathogenesis, linking pancreatitis and type 2 diabetes mellitus. Chapter 3 describes a study in which we collaborated with a gerontologist interested in predicting cognitive decline in senior patients. In this study, we attempt such predictions by using accelerometry data collected from Chicago's south side community and implementing advanced machine learning methods for predicting patients' future clinical trajectories. In Chapter 4, we identify the novel, hip fracture risk factors and investigate whether statistical survival analysis could improve upon existing tools' accuracy. In Chapter 5, we constructed a state-of-art machine learning tool on fracture detection on patients’ broad prior disease history. Lastly, Chapter 6 summarizes the above projects and suggests future directions for our exploration of statistical learning from complex medical data. We also discuss our studies' potential importance for statistical learning from medical data and outline the problems that remain open in the field

UV-triggered Transient Electrospun Fiber Mats from Poly(Propylene Carbonate)/Poly(Phthalaldehyde) Polymer Blends

Low-ceiling temperature polymers with triggered transience have gained attention due to their potential applications in multiple fields, ranging from lithography to decomposable packaging, as well as for channel manufacturing in microfluidic devices. Besides the development of novel transient materials, advanced electrospinning techniques have also been utilized to increase a materials surface area, which can result in a faster decomposition rate. Thus, it would be of interest to explore the unique characterization of electrospun transient fiber mats made of low-ceiling temperature polymers and their potential usage as support substrate for microelectronic devices. This work reports the first transient electrospun nanofiber mat triggered by UV-irradiation using poly(propylene carbonate) (PPC)/poly(phthalaldehyde) (cPPA) polymer blends. The ability to trigger room temperature transience in nanofibers mats without the need for additional heat or solvent expands its utility in non-biological fields, especially for transient electronic devices. The addition of a photoacid-generator (PAG) to the system working in combination with UV light provides an acid source to enhance degradation since both polymer backbones are acid-sensitive. Electrospinning enables the production of PPC/cPPA composite nanofiber mats capable significant degradation upon exposure to UV radiation while maintaining relatively high mechanical properties. An acid amplifier (AA), an auto-catalytically decomposing compound triggered by acid, was used to generate more acid and accelerate nanofiber degradation. The electrospun fiber mats can be post-annealed to achieve an improved mat mechanical strength of ~ 170 MPa

Effect of Thermophilic Microbial Agents on Antibiotic Resistance Genes and Microbial Communities during Co-Composting of Pig Manure and Tea Stalks

Antibiotic resistance caused by antibiotic resistance genes (ARGs) threatens human health. ARGs in animal manure can be degraded by composting. This study explored the changes in ARGs and microbial communities during co-composting of pig manure and tea stalks with (T) thermophilic microbial agents, including Geobacillus toebii ZF1 and Geobacillus sp. ZF2 for 15 days in a 4 L vacuum flask. Composting without thermophilic microbial agents served as control (CK). The results showed that the compost temperature of group T peaked at 72.1 °C and maintained above 70 °C for 4 days. The maximum temperature of group CK was 64.0 °C. The seed germination index showed that group T had reached maturity on day 9, while group CK reached maturity on day 15. The dominant bacteria in group CK were Bacillus. In group T, the dominant bacteria changed from Bacillus and Corynebacterium to Geobacillus. Compared with that of group CK, group T increased the removal of cmx, baeS and TaeA by 24.6%, 18.6% and 12.1%, respectively. Group T promoted and inhibited the removal of arlR and novA, respectively (p Dietzia, Clostridium and Corynebacterium (p cmx and baeS. These results showed that thermophilic microbial agents could accelerate the maturation of pig manure and tea stalks, change microbial communities and promote the removal of ARGs. It is of great significance to reduce the spread of ARGs and, in turn, human health risks

Organocatalytic oxa/aza-Michael–Michael Cascade Strategy for the Construction of Spiro [Chroman/Tetrahydroquinoline-3,3′-oxindole] Scaffolds

A new useful and effective chiral amine-catalyzed oxa- and aza-Michael–Michael cascade methodology for the construction of enantiomerically enriched indolinones spiro-fused with chromans or tetrahydroquinolines is reported. By employing suitable organocatalysts depending on the different Michael donors (Ar-OH/Ar-NHR), the processes offered excellent stereocontrol (dr >20:1, >99% ee) under mild conditions

Intrinsically Disordered Proteins as Important Players During Desiccation Stress of Soybean Radicles

Intrinsically disordered proteins (IDPs) play a variety of important physiological roles in all living organisms. However, there is no comprehensive analysis of the abundance of IDPs associated with environmental stress in plants. Here, we show that a set of heat-stable proteins (i.e., proteins that do not denature after boiling at 100 °C for 10 min) was present in R0mm and R15mm radicles (i.e., before radicle emergence and 15 mm long radicles) of soybean (Glycine max) seeds. This set of 795 iTRAQ-quantified heat-stable proteins contained a high proportion of wholly or highly disordered proteins (15%), which was significantly higher than that estimated for the whole soybean proteome containing 55,787 proteins (9%). The heat-stable proteome of soybean radicles that contain many IDPs could protect lactate dehydrogenase (LDH) during freeze–thaw cycles. Comparison of the 795 heat-stable proteins in the R0mm and R15mm soybean radicles revealed that many of these proteins changed abundance during seedling growth with 170 and 89 proteins being more abundant in R0mm and R15mm, respectively. KEGG analysis identified 18 proteins from the cysteine and methionine metabolism pathways and nine proteins from the phenylpropanoid biosynthesis pathway. As an important type of IDP related to stress, 30 late embryogenesis abundant proteins were also found. Ten selected proteins with high levels of predicted intrinsic disorder were able to efficiently protect LDH from the freeze–thaw-induced inactivation, but the protective ability was not correlated with the disorder content of these proteins. These observations suggest that protection of the enzymes and other proteins in a stressed cell can be one of the biological functions of plant IDPs

Insights into nano-mechanical degradation behavior of Ag/Ti2AlC composite under different arc erosion stages

Serious arc erosion is the main reason for premature failure of the Ag-matrix composite electrical contact materials in actual service. Clarifying the structure and property degradation process is crucial for creating eco-friendly Ag/MAX electrical contacts and upgrading high-performance materials for low-voltage switch applications. In this study, the representative Ag/Ti2AlC electrical contacts were designed into three arc erosion stages (from 1 to 5610 cycles) by ex-situ arc discharging experiment, and the nanoindentation technique was then applied to in-depth analyze the evolution behavior of nano-mechanical properties by comparing nano hardness, modulus, creep, continuous stiffness, elastic/plastic deformation, and NanoBlitz 3D Mapping indentation results in different erosion stages. Finally, the inherent relationship among the structural dissociation of Ti2AlC, and compositional changes of Ag/Ti2AlC interface and nano-mechanical properties of composite was revealed, and the material degradation model and anti-arc erosion mechanism were proposed. This work further elucidates the intrinsic source of excellent arc erosion resistance and degradation process of Ag/Ti2AlC composite from the nano-mechanical perspective and lays a theoretical foundation for the future design and optimization of this material system

Chiral Tertiary Amine Thiourea-Catalyzed Asymmetric Inverse-Electron-Demand Diels–Alder Reaction of Chromone Heterodienes Using 3‑Vinylindoles as Dienophiles

A straightforward and efficient protocol for the construction of structurally and biologically interesting chiral flavanoids incorporating three privileged structures, i.e., chromanone, dihydropyran, and indole, has been developed on the basis of chiral bifunctional tertiary amine thiourea-catalyzed asymmetric inverse-electron-demand Diels–Alder reaction of chromone heterodienes and 3-vinylindoles, which were used as dienophiles

Effect of Thermophilic Microbial Agents on Crude Fiber Content, Carbohydrate-Active Enzyme Genes, and Microbial Communities during Chinese Medicine Residue Composting

The objective of this study was to investigate the impact of thermophilic bacteria on crude fiber content, carbohydrate-active enzyme (CAZyme) genes, and associated microbial communities during Chinese medicine residues composting. The study examines changes over 15 days of composting with (T) and without (CK) thermophilic microbial agents. Results show that the group T compost temperature reached a maximum of 71.0 °C and remained above 70 °C for 2 days, while the group CK maximum temperature was only 60.9 °C. On Day 15, the seed germination index (GI) of group T reached 98.7%, while the group CK GI was only 56.7%. After composting, the degradation rates of cellulose, hemicellulose, and lignin in group T increased by 5.1, 22.5, and 18.5%, respectively, compared to those in group CK. Thermophilic microbial agents changed the microbial communities related to CAZymes, increasing unclassified_o_Myxococcales and Sphaerobacter abundance and reducing Acinetobacter and Sphingobacterium abundance. Thermophilic microbial agents also increased the abundance of the GT4, GT2_Glycos_transf_2, and AA3 gene families. These results show that thermophilic microbial agents can increase composting temperature, accelerate compost maturation, and promote crude fiber degradation. Therefore, they have broad application potential