A dopant-assisted iodide-adduct chemical ionization time-of-flight mass spectrometer based on VUV lamp photoionization for atmospheric low-molecular-weight organic acids analysis.

Formic and acetic acids are the most abundant gaseous organic acids and play the key role in the atmospheric chemistry. In iodine-adduct chemical ionization mass spectrometry (CIMS), the low utilization efficiency of methyl iodide and humidity interference are two major issues of the vacuum ultraviolet (VUV) lamp initiated CIMS for on-line gaseous formic and acetic acids analysis. In this work, we present a new CIMS based on VUV lamp, and the ion-molecular reactor is separated into photoionization and chemical ionization zones by a reducer electrode. Acetone was added to the photoionization zone, and the VUV photoionization acetone provided low-energy electrons for methyl iodide to generate I-, and the addition of acetone reduced the amount of methyl iodide by 2/3. In the chemical ionization zone, a headspace vial containing ultrapure water was added for humidity calibration, and the vial changes the sensitivity as a function of humidity from ambiguity to well linear correlation (R2 > 0.95). With humidity calibration, the CIMS can quantitatively measure formic and acetic acids in the humidity range of 0%-88% RH. In this mode, limits of detection of 10 and 50 pptv are obtained for formic and acetic acids, respectively. And the relative standard deviation (RSD) of quantitation stability for 6 days were less than 10.5%. This CIMS was successfully used to determine the formic and acetic acids in the underground parking and ambient environment of the Shandong University campus (Qingdao, China). In addition, we developed a simple model based formic acid concentration to assess vehicular emissions.

Antioxidant anthocyanin synergistic immune enhancer nanopeptide C-I20 remarkably enhances the protective effect of largemouth bass against largemouth bass ranavirus.

Largemouth bass ranavirus (LMBV) infection results in huge economic losses in largemouth bass (Micropterus salmoides) industry. Nanopeptide C-I20 and anthocyanins have a positive effect on promoting immune responses and antioxidant mechanisms in several aquatic organisms, and are therefore used to inhibit LMBV infection. In this study, we developed an LMBV immersion challenge model using three different viral concentrations (1×104 copies/mL, 1×105 copies/mL, and 1×106 copies/mL) to infect largemouth bass, and LMBV-MCP mRNA expression was detected in infected fish. Following infection, the fish exhibited severe external ulceration, redness swelling, and darkening of the skin. Histopathological examination revealed significant necrosis and inflammation in muscle tissue, epithelial cell shedding in renal tubules, macrophage aggregation centers and cellular vacuolization in spleen and head kidney, and cellular hypertrophy in liver. To mitigate LMBV infection, we explored the protective effects of a combined treatment strategy involving C-I20 and anthocyanin. Overall, the combination of anthocyanin and C-I20 demonstrated the highest protective efficacy, significantly reducing viral loads in muscle, liver, spleen, and head kidney. Moreover, this treatment regimen enhanced antioxidant enzyme activities (T-AOC, TSOD, GSH-Px, CAT) and modulated important immune genes (IL-1, IL-8, TNF-α, IL-10, Mx, and IgM) expression. In conclusion, the synergistic application of anthocyanin and C-I20 demonstrates significant efficacy in mitigating LMBV infection. This research introduces a novel and promising approach to managing infectious diseases in aquaculture settings.

Germacrane-type sesquiterpenes from Artemisia atrovirens and their anti-inflammatory activity.

Artemisia plants are well-known for their abundant sesquiterpene compounds, which encompass various structural types and exhibit a range of biological activities. In this study, a systematic investigation of Artemisia atrovirens revealed the presence of germacrane-type sesquiterpenes for the first time. This included the discovery of 10 new compounds and three known analogues, among which were two rare dimeric germacrane-type compounds. Their structures were fully characterized through a comprehensive analysis involving MS, IR, 1D- and 2D-NMR spectroscopic data, single crystal X-ray diffraction, density functional theory (DFT) NMR calculations, and time-dependent DFT electronic circular dichroism (TDDFT ECD) calculations. Furthermore, all isolated compounds were evaluated for their anti-inflammatory activity in LPS-stimulated RAW 264.7 murine macrophages. Compound 10 demonstrated a potent inhibitory effect on NO production, with an IC50 value of 4.01 ±â€¯0.09 µM. This study highlights the diverse chemical repertoire of Artemisia species and underscores their potential in drug discovery and development.

Investigating Acoustic and Psycholinguistic Predictors of Cognitive Impairment in Older Adults: Modeling Study.

BACKGROUND: About one-third of older adults aged 65 years and older often have mild cognitive impairment or dementia. Acoustic and psycho-linguistic features derived from conversation may be of great diagnostic value because speech involves verbal memory and cognitive and neuromuscular processes. The relative decline in these processes, however, may not be linear and remains understudied. OBJECTIVE: This study aims to establish associations between cognitive abilities and various attributes of speech and natural language production. To date, the majority of research has been cross-sectional, relying mostly on data from structured interactions and restricted to textual versus acoustic analyses. METHODS: In a sample of 71 older (mean age 83.3, SD 7.0 years) community-dwelling adults who completed qualitative interviews and cognitive testing, we investigated the performance of both acoustic and psycholinguistic features associated with cognitive deficits contemporaneously and at a 1-2 years follow up (mean follow-up time 512.3, SD 84.5 days). RESULTS: Combined acoustic and psycholinguistic features achieved high performance (F1-scores 0.73-0.86) and sensitivity (up to 0.90) in estimating cognitive deficits across multiple domains. Performance remained high when acoustic and psycholinguistic features were used to predict follow-up cognitive performance. The psycholinguistic features that were most successful at classifying high cognitive impairment reflected vocabulary richness, the quantity of speech produced, and the fragmentation of speech, whereas the analogous top-ranked acoustic features reflected breathing and nonverbal vocalizations such as giggles or laughter. CONCLUSIONS: These results suggest that both acoustic and psycholinguistic features extracted from qualitative interviews may be reliable markers of cognitive deficits in late life.

Resolving Atmospheric Oxygenated Organic Molecules in Urban Beijing Using Online Ultrahigh-Resolution Chemical Ionization Mass Spectrometry.

Gaseous oxygenated organic molecules (OOMs) are crucial precursors of atmospheric organic aerosols. OOMs in urban atmospheres have complex compositions, posing challenges to understanding their formation, evolution, and influences. In this study, we identify 2403 atmospheric gaseous OOMs in urban Beijing using online nitrate-based chemical ionization Orbitrap mass spectrometry based on one-year atmospheric measurements. We find that OOMs in urban atmospheres can be identified with higher accuracy and wider coverage, compared to previously used online mass spectrometry. With optimized OOM resolving capabilities, previous knowledge of OOMs in urban atmospheres can be expanded. First, clear homologous and oxygen-addition characteristics of the OOMs are revealed. Second, OOMs with lower concentrations or higher masses are identified and characterized with high confidence, e.g., OOMs with masses above 350 Da. In particular, dimers of OOMs (e.g., C20H32O8-15N2), crucial species for organic nucleation, are identified. During four seasons, nitrogen-containing OOMs dominate the total concentration of OOMs, and OOMs are mainly from aromatic and aliphatic oxidation. Additionally, radicals with similar composition as OOMs, intermediates for OOM formation, are identified with clear diurnal variation, e.g., CnH2n-5O6 radicals (n = 8-10) and CmH2m-4NO9 radicals (m = 9-10), peak during the daytime and nighttime, respectively, previously having scarce measurement evidence in urban atmospheres.

Highly Durable Chemoresistive Micropatterned PdAu Hydrogen Sensors: Performance and Mechanism.

Hydrogen (H2) is a promising alternative energy source for Net-zero, but the risk of explosion requires accurate and rapid detection systems. As the use of H2 energy expands, sensors require high performance in a variety of properties. Palladium (Pd) is an attractive material for H2 detection due to its high H2 affinity and catalytic properties. However, poor stability caused by volume changes and reliability due to environmental sensitivity remain obstacles. This study proposes a micropatterned thin film of PdAu with optimized composition (Pd0.62Au0.38) as a chemoresistive sensor to overcome these issues. At room temperature, the sensor has a wide detection range of 0.0002% to 5% and a fast response time of 9.5 s. Significantly, the sensor exhibits excellent durability for repeated operation (>35 h) in 5% H2 and resistance to humidity and carbon monoxide. We also report a negative resistivity change in PdAu, which is opposite to that of Pd. Density functional theory (DFT) calculations were performed to investigate the resistance change. DFT analysis revealed that H2 penetrates specific interstitial sites, causing partial lattice compression. The lattice compression causes a decrease in electrical resistance. This work is expected to contribute to the development of high-performance H2 sensors using Pd-based alloys.

The Long-Term Effect of Cochlear Implantation on Tinnitus: A Systematic Review and Meta-Analysis.

OBJECTIVE: This systematic review investigates the long-term effect of cochlear implantation (CI) on clinical outcomes in tinnitus patients with sensorineural hearing loss (SNHL). DATABASE SOURCES: PubMed, Embase, and the Cochrane Library were searched from inception to 30 April 2024. Manual searches of reference lists supplemented these searches when necessary. REVIEW METHODS: Original studies included in the meta-analysis had to contain comparative pre- and postoperative data for SNHL patients who underwent CI. Outcomes measured were the Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS), and Tinnitus Questionnaire (TQ). RESULTS: A total of 28 studies comprising 853 patients showed significant tinnitus improvement after CI: THI mean difference (MD) -14.02 [95%CI -15.29 to -12.76, p < 0.001], TQ MD -15.85 [95%CI -18.97 to -12.74, p < 0.05], and VAS MD -3.12 [95%CI -3.49 to -2.76, p < 0.05]. Subgroup analysis indicated a significant difference between follow-up periods in THI (p < 0.0001) and VAS loudness (p = 0.02). CONCLUSIONS: Cochlear implantation substantially improves tinnitus in patients with hearing loss, though the effect may diminish over time. Further research is needed to confirm these findings.

Analytical performance evaluation of a new integrated clinical chemistry and immunoassay analyzer.

Background: Clinical laboratories perform a wide range of tests that are used by healthcare professionals to guide medical decision making. Use of automated analyzers in the clinical laboratory can improve patient care by not only reducing the turn-around-time (TAT) of results but also improving accuracy of the reported results by reducing human error. The aim of this study was to evaluate the performance characteristics of a new automated laboratory instrument, the Atellica® CI Analyzer, Model 1900, over a 3-month period in a European laboratory setting. Methods: Analytical performance of 17 analytes (13 chemistry and four immunochemistry) was assessed by evaluating repeatability and within-laboratory precision using anonymized remnant serum samples. Method comparison studies were performed on the Atellica CI Analyzer and the Roche cobas® 6000. Results: Excellent precision was observed with coefficients of variation (CVs) less than 2 % for repeatability and less than 3 % within-laboratory imprecision for most analytes. Comparison of select assays with the cobas 6000 system resulted in correlation coefficients ranging from 0.980 to 1.000. Conclusion: This is the first reported evaluation of the Atellica CI Analyzer in a clinical laboratory setting. The strong analytical performance of the Atellica CI Analyzer demonstrates that this instrument is suitable for routine clinical use.

Precision matters: the value of PET/CT and PET/MRI in the clinical management of cervical cancer.

The incidence of cervical cancer has been increasing recently, becoming an essential factor threatening patients' health. Positron emission computed tomography (PET/CT) and positron emission tomography/magnetic resonance imaging (PET/MRI) are multimodal molecular imaging methods that combine functional imaging (PET) and anatomical imaging (CT) with MRI fusion technology. They play an important role in the clinical management of patients with cervical cancer. Precision radiotherapy refers to the use of advanced intensive modulated radiotherapy (IMRT) to give different doses of radiation to different treatment areas to achieve the purpose of killing tumors and protecting normal tissues to the greatest extent. At present, pelvic target delineation is mostly based on CT and MRI, but these mostly provide anatomical morphological information, which is difficult to show the internal metabolism of tumors. PET/CT and PET/MRI combine information on biological function, metabolism and anatomical structure, thereby more accurately distinguishing the boundaries between tumor and non-tumor tissues and playing a positive guiding role in improving radiotherapy planning (RTP) for cervical cancer and evaluating treatment effect.

Facile Synthesis of Potassium Decahydrido-Monocarba-closo-Decaborate Imidazole Complex Electrolyte for All-Solid-State Potassium Metal Batteries.

All-solid-state potassium metal batteries have caught increasing interest owing to their abundance, cost-effectiveness, and high energy/power density. However, their development is generally constrained by the lack of suitable solid-state electrolytes. Herein, we report a new complex KCB9H10·2C3H4N2, synthesized by grinding and heating the mixture of potassium decahydrido-monocarba-closo-decaborate (KCB9H10) and imidazole (C3H4N2) under mild conditions, to achieve the K-ion superionic solid-state electrolyte. The crystal structure was revealed as an orthorhombic lattice with the space group of Pna21 by FOX software. The diffusion properties for K+ in the crystal structure were calculated using the climbing image nudged elastic band (CI-NEB) method. KCB9H10·2C3H4N2 exhibited a high ionic conductivity of 1.3 × 10-4 S cm-1 at 30 °C, four orders of magnitude higher than that of KCB9H10. This ionic conductivity is also the highest value of hydridoborate-based K+ conductors reported. Moreover, KCB9H10·2C3H4N2 demonstrated a K+ transference number of 0.96, an electrochemical stability window of 1.2 to 3.2 V vs. K/K+, and good stability against the K metal coated by a layer of potassium imidazolate (KIm). These great performances make KCB9H10·2C3H4N2 a promising K-ion solid-state electrolyte.

A Critical Investigation of Sick Euthyroid Syndrome in Chronic Heart Failure Patients: Addressing the Need for Accurate Thyroid Assessment.

Background The body undergoes numerous metabolic changes during severe illness or physiological stress to protect itself by lowering metabolism and reducing overall demands. This evolutionary adaptation dates back to early human development, long before the advent of ICU facilities and advanced treatments. One such protective mechanism is Sick Euthyroid Syndrome (SES), also known as Non-thyroidal Illness Syndrome (NTIS). SES commonly occurs in critically ill patients and is frequently observed in conditions such as heart failure, chronic kidney disease, and severe sepsis. This syndrome is characterized by abnormal thyroid function tests in patients with acute or chronic systemic illnesses who do not have intrinsic thyroid disease. Typically, these patients exhibit low serum levels of triiodothyronine (T3), normal or low levels of thyroxine (T4), and normal or low thyroid-stimulating hormone (TSH) levels. SES is believed to be an adaptive response to illness, aimed at reducing the body's metabolic rate and conserving energy during severe physiological stress. This original article delves into SES's prevalence and clinical impact in these settings. Materials and methods The study aims to determine the prevalence of SES in patients with long-standing heart failure, elucidate the relationship between thyroid function and heart failure severity, and assess its impact on various hematological and clinical parameters. This observational, cross-sectional study was conducted at Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, India, a 2011-bed hospital, over one and a half years. This study included 70 patients with chronic heart failure, aged 18 years and above, defined by a left ventricular ejection fraction of 40% or less and a Boston criteria score of 8 or more. Patients were excluded if they had a history of thyroid dysfunction, clinical sepsis, or were taking thyroid-affecting drugs.  Results The study provides important insights into the prevalence and impact of SES in long-standing heart failure patients. It found that a significant 44.29% of these patients exhibited low T3 levels, highlighting the substantial occurrence of SES in this population. Additionally, the study revealed a negative correlation between N-terminal pro-b-type natriuretic peptide (NT-proBNP) levels, Boston score, and total T3, suggesting that as indicators of heart failure severity worsen, total T3 levels may decrease further. Another key finding is the high prevalence of anemia among heart failure patients, with a notable gender disparity: 92.11% of male patients were affected compared to 50% of female patients.  Conclusion The study concluded that SES is significantly prevalent among long-standing heart failure patients, further indicating that thyroid suppression increases with the severity of heart failure. Recognizing SES can guide tailored treatments, prompting intensive monitoring and optimized heart failure management. Additionally, the study found a high prevalence of anemia, particularly among male patients, highlighting the need for gender-specific considerations in managing heart failure. These findings underscore the importance of routine thyroid function assessments and regular monitoring of anemia in heart failure patients. Future research should focus on improving clinical outcomes through comprehensive management of both thyroid function and anemia in these patients.

Performance and emission profiles of petroleum nut (Pittosporum resineferum Hemsl.) biodiesel in combustion ignition engine-generator for power generation.

One of the traditional fuels for power generation in the Philippines is the petroleum diesel (PD). However, its extensive usage contributes to environmental degradation, health risks and climate change concerns. Alternative fuels such as petroleum nut biodiesel (PNB) may address the increasing consumption of PD amidst depleting fossil reserves and related issues. This study aimed to produce, characterize, and observe the behavior of PNB as a fuel in a compression ignition (CI) engine-power generation system at various loads of 0 %, 25 %, 50 %, 75 % and 100 %. Petroleum nut fruits were collected, extracted of oil then transesterified to produce PNB. The performance and emission profiles of the latter were determined. Degumming increased the PNB yield by 24.28 %. Additional refining decreased colorants and impurities. Majority of the chemical and physical properties of the PNB showed comparable values with those of PD. Various blends of PNB-PD were prepared and tested in terms of their performance and emissions. The 20 % PNB mixed with 80 % PD (B20) showed the most efficient performance after 100 % PD with at least 3.95 % decrease, whereas PNB for specific fuel consumption (SFC) showed at most 30.78 % higher than all fuels for all loads. The heat release rate (HRR) increases with increasing %PNB in the PNB-PD blend. PNB generally showed the highest CO2 and NOx emissions with at least 16.67 % and 80.52 % lower with PD respectively, but the lowest for CO emission with at least 13.42 % difference compared with PD. Finally, the study confirms that CI engine-generator can be operated with 100 % PNB and its blends without engine modification.

Correlation between ultrasonographic and cytologic features of thyroid nodules: a single-center cross-sectional study.

A thyroid nodule is managed according to the clinical context, ultrasound (US) findings, and fine needle aspiration (FNA) results. Most thyroid nodules are benign; however, nodule classification is crucial to avoid unnecessary thyroid surgery. We conducted this study to compare the findings of fine-needle aspiration cytology (FNAC) expressed using the Bethesda system with the features of thyroid US classified using the EU-TIRADS classification to assess the risk of malignancy. A descriptive and analytical study involving 99 patients with thyroid nodules followed up in the Department of Endocrinology-Diabetology and Nutrition. Data were collected from medical records and analyzed using SPSS software V21. FNA was performed on 121 nodules using the BETHESDA system. These nodules were classified as malignant, suspicious for follicular neoplasm, and suspicious for malignancy in 5.8%, 5%, and 1.7% of cases, respectively. As for the EU-TIRADS 2017 classification, 59.5% of benign nodules were classified as EU-TIRADS III, whereas 66.7% of malignant nodules were classified as EU-TIRADS V and significantly related to malignant prediction (P = 0.000). The size of nodules was significantly correlated to the risk of malignancy (P = 0.013). Seventy-five percent of nodules with central vascularity were malignant (P = 0.012). Irregularity of nodule contours was significantly associated with the risk of malignancy, as 30% of nodules with irregular contours were Bethesda VI (P = 0.003). Hypoechogenicity was found in 77.8% of malignant nodules (P = 0.004). Additionally, only 9.2% of the nodules were taller than wide, of which 37.5% were malignant (P = 0.012). For a safe management strategy, US-guided FNAC should be performed on each suspicious thyroid nodule, given the correlation between EU-TIRADS classification features and the risk of malignancy.

Illness perceptions in cochlear implant users - a longitudinal study.

PURPOSE: 'Illness perceptions' refers to the thoughts and ideas a person has about an illness. According to Leventhal's Self-Regulatory Model (SRM), changing the threatening illness perceptions of cochlear implant (CI) recipients can be a further step in optimizing hearing outcomes with the CI. The aims of the present study were to assess users' illness perceptions and to determine whether perceptions change during six months of CI rehabilitation. METHODS: One hundred and thirty-eight participants completed the Brief Illness Perception Questionnaire (Brief IPQ), assessing their illness perceptions on nine scales. Data were collected at a German CI center at first CI fitting and six-month follow-up. After first fitting, participants underwent intensive rehabilitation including auditory training, medical, audiological and psychological treatments. RESULTS: At both assessments, participants tended to view their hearing impairment as a severe threat. On the Brief IPQ, the 'consequences' assessment improved during CI rehabilitation, which can be explained by the CI-induced hearing improvement. However, 'understanding' and 'identity' assessments worsened. This could be because CI recipients only come to realize the full complexity of their hearing impairment during rehabilitation. The other scales and the total score remained unaffected. CONCLUSIONS: Current practice in CI rehabilitation seems to be insufficient to improve threatening illness perceptions (except for perceived consequences). This may be because standard information often fails to reach the patients. The development and empirical validation of an intervention program to address individual illness perceptions in CI recipients could be helpful in this context. Further research will be needed to confirm the results.

Asymptotic Confidence Interval, Sample Size Formulas and Comparison Test for the Agreement Intra-Class Correlation Coefficient in Inter-Rater Reliability Studies.

The agreement intra-class correlation coefficient (ICCa) is a suitable statistical index for inter-rater reliability studies. With balanced Gaussian data, we prove the explicit form of ICCa asymptotic normality (ASN), valid both with analysis of variance (ANOVA), maximum likelihood (ML), or restricted ML (REML) estimates. An asymptotic confidence interval is then derived and its performances are examined by simulation compared to the most commonly used methods, under small, moderate and large sample size designs. Then, we deduce sample size calculation formulas, for the number of subjects and observers needed, to achieve a desired confidence interval width or an acceptable ICCa value test power and give concrete examples of their use. Finally, we propose a likelihood ratio test (LRT) to compare two ICCa's from two distinct subpopulations of patients (or raters) and study by simulation its first order risk and power properties. These methods are illustrated using data from two inter-rater reliability studies, one in physiotherapy with 42 patients and 10 raters and the second in neonatology with 80 subjects and 14 raters. In conclusion, we made recommendations to employ the proposed confidence interval for medium to large samples combined with the quantification of the minimal required sample size at the planning step, or the posterior-power at the analysis step, using simple dedicated formulas. Furthermore, with sufficient sizes, the proposed LRT seems suitable to compare inter-rater reliability between two patient subpopulations. Used wisely, this proposed methods toolbox can remedy common current issues in inter-rater reliability studies.

Surrogates of Endothelial Injury Predict Survival After Post-transplant Cyclophosphamide.

Post-transplant cyclophosphamide (PT-Cy) is becoming the standard of care for preventing graft-versus-host disease (GVHD) following allogeneic hematopoietic stem cell transplant (alloHCT). Cyclophosphamide is associated with endothelial injury. We hypothesized that the endothelial activation and stress index (EASIX) score, being a marker of endothelial dysfunction, will predict non-relapse mortality (NRM) in alloHCT patients receiving PT-Cy for GVHD prophylaxis. We evaluate the prognostic ability of the hematopoietic cell transplantation-specific comorbidity index (HCT-CI) and EASIX scores, and report other factors influencing survival, in patients with hematologic malignancies undergoing alloHCT and receiving PT-Cy-based GVHD prophylaxis. Adult patients with hematologic malignancies who underwent alloHCT and received PT-Cy for GVHD prophylaxis at the three Mayo Clinic locations were included in this study. We retrospectively reviewed the Mayo Clinic database and the available electronic medical records to determine the patient, disease, and transplant characteristics. An HCT-CI score of ≥3 was considered high. The EASIX score was calculated from labs available between day -28 (of alloHCT) to the day of starting conditioning and analyzed on log2 transformed values. A log2-EASIX score ≥2.32 was considered high. The cumulative incidence of NRM was determined using competing risk analysis, with relapse considered as competing risk. Overall survival (OS) from transplant was determined using Kaplan-Meier and log-rank methods. Cox-proportional hazard method was used to evaluate factors impacting survival. A total of 199 patients were evaluated. Patients with a high log2-EASIX score had a significantly higher cumulative incidence of NRM at 1 year after alloHCT (34.5% versus 12.3%, P = .003). Competing risk analysis showed that a high log2-EASIX score (HR 2.92, 95% CI 1.38 to 6.17, P = .005) and pre-alloHCT hypertension (HR 2.15, 95% CI 1.06 to 4.36, P = .034) were independently predictive of 1 year-NRM. Accordingly, we combined the two factors to develop a composite risk model stratifying patients in low, intermediate, and high-risk groups: 111 (55.8%) patients were considered low-risk, 76 (38.2%) were intermediate and 12 (6%) were high-risk. Compared to patients in the low-risk group, the intermediate (HR 2.38, 95% CI 1.31 to 4.33, P = .005) and high-risk (HR 5.77, 95% CI 2.31 to 14.39, P < .001) groups were associated with a significantly inferior 1-year OS. Multiorgan failure (MOF) was among the common causes of NRM (14/32, 43.8%) particularly among patients with prior pulmonary comorbidities [7 (50%) patients]. Our study shows that EASIX score is predictive of survival after PT-Cy. The novel EASIX-HTN composite risk model may stratify patients prior to transplant. MOF is a common cause of NRM in patients receiving PT-Cy, particularly among patients with pulmonary comorbidities.

Close approximations to the sound of a cochlear implant.

Cochlear implant (CI) systems differ in terms of electrode design and signal processing. It is likely that patients fit with different implant systems will experience different percepts when presented speech via their implant. The sound quality of speech can be evaluated by asking single-sided-deaf (SSD) listeners fit with a cochlear implant (CI) to modify clean signals presented to their typically hearing ear to match the sound quality of signals presented to their CI ear. In this paper, we describe very close matches to CI sound quality, i.e., similarity ratings of 9.5 to 10 on a 10-point scale, by ten patients fit with a 28 mm electrode array and MED EL signal processing. The modifications required to make close approximations to CI sound quality fell into two groups: One consisted of a restricted frequency bandwidth and spectral smearing while a second was characterized by a wide bandwidth and no spectral smearing. Both sets of modifications were different from those found for patients with shorter electrode arrays who chose upshifts in voice pitch and formant frequencies to match CI sound quality. The data from matching-based metrics of CI sound quality document that speech sound-quality differs for patients fit with different CIs and among patients fit with the same CI.

Preoperative Assessment Using CT and MRI Scans of the Temporal Bone to Determine the Degree of Difficulty in Cochlear Implant Surgery.

Background Cochlear implant surgery is a complex procedure influenced by the anatomical structures of the temporal bone. Preoperative imaging using CT and MRI can provide critical insights into the surgical challenges that may be encountered. This study aims to evaluate the role of CT and MRI in preoperative assessment to predict the difficulty of cochlear implant surgery in terms of surgical time. Materials and methods A retrospective observational study was conducted at Saveetha Medical College and Hospital, Chennai, from April 2022 to September 2023. Ninety patients with severe to profound sensorineural hearing loss who underwent cochlear implantation were included. Preoperative high-resolution CT (HRCT) and MRI of the temporal bone were performed to assess various anatomical parameters. Surgical difficulty was evaluated intraoperatively and correlated with preoperative imaging findings. Data were analyzed using IBM SPSS Statistics for Windows, V. 21.0 (IBM Corp., Armonk, NY). Results The mean age of participants was 7.4±10.9 years, with the majority (66.7%) in the 1-5-year age group. Out of 90 participants, 50 were male and 40 were female. HRCT and MRI revealed that 35.6% of participants had hypo-/non-pneumatized mastoids, 3.3% had narrow facial recesses, and 3.3% had high-riding jugular bulbs. Significant correlations were found between surgical time and associated congenital (p=0.006) and acquired (p=0.0001) anomalies of the temporal bone, as well as the total difficulty score (p=0.0001). The mean surgical time was 103.97±25.2 minutes, with a range from 45 to 220 minutes. Conclusion Preoperative HRCT and MRI are valuable tools in predicting the degree of difficulty in cochlear implant surgery. Specific anatomical features identified in imaging studies can significantly influence the surgical approach and duration. These findings underscore the importance of detailed preoperative imaging to enhance surgical planning and outcomes in cochlear implant procedures.

Transesophageal echocardiography guidance for percutaneous closure of PFO and a new method to improve the diagnosis and safety during the procedures.

Purpose: Percutaneous patent foramen ovale (PFO) closure is becoming more and more common for the treatment or prevention of PFO-associated right-to-left shunt (RLS). This study aims to investigate the value of transesophageal echocardiography (TEE) in percutaneous PFO closure, and to explore a new method that can improve intraoperative diagnosis and surgical safety. Materials and methods: Based on our inclusion and exclusion criteria, we enrolled 73 patients between 16 and 70 years old (average age 43.25 ± 14.87 years) who underwent percutaneous PFO closure at the Department of Cardiac Surgery, Zhongshan Hospital (Xiamen), Fudan University, from January 2022 to December 2023. Out of the 73 enrolled patients, there were 28 males (38.36%) and 45 females (61.64%), 29 migraine patients (39.73%), 14 patients (19.19%) with headache and dizziness, 14 patients (19.18%) with a history of cerebral infarction (CI), and 25 patients (34.25%) with CI, lacunar infarction or ischemic focus on magnetic resonance imaging (MRI). All patients received routine transthoracic echocardiography (TTE) and agitated saline contrast echocardiography (ASCE) before operations. Percutaneous closure of PFO was completed under the guidance of TEE. In 12 patients, the method of "injection of heparinized sterile saline through the delivery sheath" was used to observe their RLS, and the anatomical characteristics of the PFO according to the shunt path were monitored and evaluated. This method was also applied to some patients to guide the conveyor to pass through the foramen ovale (FO) channel safely and effectively, thereby improving the success rate of PFO closure. Results: The application of TEE during the procedure of percutaneous PFO closure, including preoperative evaluation, intraoperative guidance, and postoperative reevaluation, can offer further details about the anatomical and shunt characteristics of PFO, improve the diagnosis rate, and confirm the safety of the surgical path. It ensures the safety and reliability of the whole operation, greatly improving the success rate and reducing postoperative complications. Conclusions: TEE guidance of percutaneous PFO closure has the advantages of minimal trauma, no radiation and real-time visualization, while injecting heparinized sterile saline through the delivery sheath is safer and more effective in improving the success rate and reducing postoperative complications.

[Effects of"Grain for Green "on the Spatial Distribution of Soil Carbon and Nitrogen in Purple Hilly Area of China].

In order to remedy the lack of research on the effect of "Grain for Green" on soil carbon （C） and nitrogen （N） distribution on slope soil in purple hilly areas of Sichuan Basin, China, a study was conducted on a long-term observation site established in the Wanan small watershed of Yanting Agro-ecological Experimental Station of Purple Soil, Chinese Academy of Sciences. The morphology, content, and storage of C and N in soil at different slope positions of farmland and the artificial forests in rehabilitated land with a history of approximately 30 years were compared. Our results showed that "Grain for Green" significantly increased soil organic carbon （SOC） content and SOC stock in all soil layers. The SOC stock of the surface layer （0-20 cm） increased by 25.86 t·hm-2, and the annual SOC stocks ratio was 0.89 t·hm-2. Soil total nitrogen （TN） content increased slightly but only in the 0-20 cm soil layer. Compared with those in sloping farmland, the differences in available C and N nutrients such as soil nitrate N （NO3--N）, ammonia N （NH4+-N）, and dissolved organic C （DOC） in the whole soil profile （0-70 cm） were basically not significant （P > 0.05）. In addition, our research also found that slope position had significant effects on the contents of TN, SOC, NO3--N, NH4+-N, and DOC in farmland soil （P< 0.05）. The variation trend of soil NO3--N, NH4+-N, and DOC contents along the slope was as follows： upper slope < middle slope < lower slope, whereas the soil TN and SOC contents were highest in the lower slope, followed by the upper slope and middle slope. The position of the slope had a significant impact only on DOC content in forest soil, which increased along the slope. This research indicated that when evaluating the impact of land use changes on soil C and N stocks in the purple soil hilly region, the influence of topographic factors cannot be ignored.