Development and validation of a nomogram model to predict primary graft dysfunction in patients after lung transplantation based on the clinical factors

BACKGROUND

Primary graft dysfunction (PGD), a significant complication that can affect patients' prognosis and quality of life, develops within 72 h post lung transplantation (LTx). Early detection and prevention of PGD should be given special consideration. The purpose of this study was to create a clinical prediction model to forecast the occurrence of PGD.

METHODS

We collected information on 622 LTx patients from Wuxi People's Hospital from 2016 to 2020 and used the data to construct the prediction model. Information on 224 patients from 2021 to June 2022 was used for external validation. We used LASSO regression for variable screening. A nomogram was developed for model presentation. Distinctness, fit, and calibration were used to evaluate the performance of the model.

RESULTS

Subjects with respiratory failure, who received fresh frozen plasma, donor age, donor gender, donor mechanism of death, donor smoking, donor ventilator use time, and donor PaO 2/FiO 2 ratio were independent predictor variables for the occurrence of PGD. The area under the curve of the nomogram was .779. The Hosmer-Lemeshow test showed a good model fit (P = .158). The calibration curve of the nomogram is fairly close to the ideal diagonal. Moreover, the decision curve analysis revealed a positive net benefit of the model. External validation also confirmed the reliability of the model.

CONCLUSIONS

The nomogram of PGD based on clinical risk factors in postoperative LTx patients was established with high reliability. It provides clinicians and nurses with a new and effective tool for early prediction of PGD and early intervention.

Constraints on Spin-Spin Velocity-Dependent Interactions

The existence of exotic spin-dependent forces may shine light on new physics beyond the standard model. We utilize two iron shielded SmCo_{5} electron-spin sources and two optically pumped magnetometers to search for exotic long-range spin-spin velocity-dependent force. The orientations of spin sources and magnetometers are optimized such that the exotic force is enhanced and common-mode noise is effectively subtracted. We set direct limit on proton-electron interaction in the force range from 1 cm to 1 km. Our experiment represents more than 10 orders of magnitude improvement than previous works.

Asymmetric Bargaining Model for Water Resource Allocation over Transboundary Rivers

Sustainable transboundary water governance is often challenged by conflicts between agents, which necessitates the design of cooperative and self-enforcing alternatives to facilitate equitable water distribution. The Nash bargaining approach, which originated from game theory, could offer a good mathematical framework to simulate strategic interactions among involved agents by considering individual rational benefits. Given that river-sharing problems often involve multiple self-interested agents, the asymmetric Nash bargaining solution (ANBS) could be used to describe agents' powers, as determined by disparate social, economic, and political as well as military status, and ensure win-win strategies based on individual rationality. This paper proposed an asymmetric bargaining model by combining multi-criteria decision making, bankruptcy theory, and the ANBS for water distribution in the transboundary river context. The Euphrates River Basin (ERB) with three littoral states was used as a case study. Turkey has the highest bargaining power in ERB negotiation since it dominates in terms of economic strength, political influence, and military capacity, whereas in the two downstream countries these aspects are limited due to their internal political fragmentation and weaker military status. The water satisfaction percentages of Turkey, Syria, and Iraq under the best alternative are 96.30%, 84.23%, and 40.88%, respectively. The findings highlight the necessity for synthetically considering the agent's disagreement utility and asymmetrical power when negotiating over water allocation.

[The effects of dentists'performance on the clinical effects of root canal preparation]

PURPOSE

To evaluate the effects of dentists'performance on the clinical efficacies of root canal preparation.

METHODS

164 teeth, including 66 vital teeth and 98 necrotic pulp teeth , were divided into two groups in random. All the root canals were prepared using ProTaper nickel-titanium rotary by two dentists with junior senior qualification. The incidence of instruments fracture, endodontic interappointment pain (EIP) and successful rates of root canal filling of the two groups were compared by X(2) test with SAS 6.2 software package.

RESULTS

Between the two groups, the difference of the incidence of instruments fracture in molar was significant (P<0.05). The incidence of EIP between the two groups had high significant difference (P<0.01); The difference of vital teeth and necrotic pulp teeth was significant (P<0.05) in junior dentist group. The successful rates of root canal filling had significant differences (P<0.05), especially in necrotic pulp molar teeth.

CONCLUSION

Skilled and accurate operation can improve the clinical efficacies of root canal preparation.

[A study on the accuracy of electronic root canal length measurement and its influential factors]

PURPOSE

To study the accuracy of JUSTY-II electronic apex locator and the influential factors on the accuracy of root canal working length measurement.

METHODS

148 teeth, including 71 teeth with pulpitis, 46 with necrotic pulp and 31 with apical periodontitis, were divided into two groups in random. The accuracy of electronic root canal working length measurement group was compared with that of the manual measurement group by Chi(2) test. The influence of clinical types, root canal in dry or moisture conditions and root canal preparation on the accuracy of root canal working length measurement was analyzed.

RESULTS

The accuracy of electronic apex locator was 87.84%, while it was 43.24% in manual measurement, the difference was significant (P<0.01). The accuracy in the group of apical periodontitis was significantly lower than that of the other groups (P<0.05). Root canal in dry or moisture conditions had no effect on the accuracy of root canal length measurement, but root canal preparation could decrease the accuracy of measurement (P<0.05).

CONCLUSION

Electronic apex locator is an accurate and convenient device in measurement of root canal working length. Apical periodontitis and root canal preparation can decrease the accuracy of measurement.

[Clinical study of the effect of preventing dentine hypersensitiveness by using Fluor Protector and Green Or on the prepared vital pulp abutment teeth]

PURPOSE

To study and evaluate the effect preventing dentine hypersensitiveness by using Fluor Protector or Green Or on the prepared vital pulp abutment teeth of PFM bridges.

METHODS

118 cases, 246 prepared vital pulp abutment teeth, were randomly divided into three groups: Experimental Group A--treated with the Fluor Protector and temporary crown; Experimental Group B--treated with the Green Or and temporary crown, and Control Group--only using temporary crown. The results of desensitization in 3 groups were evaluated. F test was used for analysis (DSPV6.01).

RESULTS

Significant differences were found between experimental Group A, B and the control group after 1 week (when cementing the PFM bridges); and also after 1 month (P<0.05). But no significant difference was found between experimental Group A and B (P>0.05).

CONCLUSIONS

The effect of preventing dental hypersensitiveness by using Fluor Protector or Green Or on the prepared vital pulp abutment teeth of PFM bridges is ideal. It is easy to use and worth being widely applied.

[A comparison of the effect between Vitapex paste and antibiotic paste in apexification.]

PURPOSE

To study the effects of two root canal filling material in the apexification.

METHODS

172 juvenile permanent teeth,including 62 teeth with pulpitis, 32 teeth with necrotic pulp and 78 teeth with periapical periodontitis, were divided into two groups.The root canal was filled with Vitapex paste and antibiotic paste.Every patient was examined once three months.The treatment lasted 6-30 months.The outcome of treatment was investigated for three years following treatment.

RESULTS

The effective rate in the group of Vitapex paste and antibiotic paste group were 86.0% and 91.9% (P>0.05).In periapical periodontitis group,the effective rate of antibiotic paste group was significantly higher than the other (P<0.05).

CONCLUSION

Both Vitapex paste and antibiotics paste were good filling materials in apexification. Antibiotic paste was better than the other in periapical periodontitis group.

Laser acupuncture anaesthesia and therapy in People's Republic of China

Laser acupuncture anaesthesia has been utilized for operations on thyroid and stomach, and Caesarean sections since 1978 in China. Recently, satisfactory results were reported in stomatology for the extraction of teeth. Laser beams directed at predetermined acupoints produce insensibility in a few minutes without any side effects such as allergy, intoxication, haemorrhage, or infection. This method has been used successfully on more than 5,000 patients for tooth extractions and minor oral and facial operations. Until now, the mechanism of classical acupuncture anaesthesia has been more or less elucidated by the neural or neuro-humoral hypothesis, which states that deep receptors or minute nerve fibres are stimulated mechanically by the needle. But laser irradiation as a stimulant is something different, since it has only low power and short penetration depth, and arouses almost no sensation compared with the acupuncture needle. The mechanism of anaesthesia due to laser irradiation of acupoints on superficial parts of the body should be investigated in further detail. The methods of laser acupuncture anaesthesia, the selection of laser irradiation acupuncture points, the distance and duration of irradiation, and the results of clinical application will be introduced.