ABO blood types may affect transient neurological events after surgical revascularization in patients with moyamoya disease: a retrospective single center study.

BACKGROUND: Moyamoya disease (MMD) is a cerebrovascular disease with unknown cause. Patients with MMD disease usually experience transient neurological events (TNEs) after revascularization surgery. This retrospective single-center study was aimed to explore the risk factors of postoperative TNEs after surgical revascularization in patients with MMD. METHODS: We selected 324 patients who underwent surgical revascularization between January 2017 and September 2022 in our center. The perioperative characteristics of the patients were recorded and the outcome was TNEs after surgery. An analysis of risk factors contributing to postoperative TNEs by using logistic regression model. RESULTS: Three hundred twelve patients were enrolled, and the incidence of postoperative TNEs was 34% in our study. Males were more likely to suffer from postoperative TNEs (OR = 2.344, p = 0.002). Preoperative ischemic presentation (OR = 1.849, p = 0.048) and intraoperative hypotension (OR = 2.332, p = 0.002) were associated with postoperative TNEs. Compared to patients with blood type O, patients with blood type A (OR = 2.325, p = 0.028), B (OR = 2.239, p = 0.027) and AB (OR = 2.938, p = 0.019) had a significantly higher incidence of postoperative TNEs. A risk prediction model for postoperative TNEs was established, and the established risk prediction area under the receiver operating characteristic curve (ROC) of the model was 0.741. CONCLUSIONS: Males, preoperative ischemic presentation and intraoperative hypotension were associated with postoperative TNEs. We also found a possible link between postoperative TNEs and ABO blood types after surgical revascularization for moyamoya patients.

Effect of Oral Care Solution on Sore Throat After I-Gel Laryngeal Mask General Anesthesia: A Randomized Controlled Trial.

Background: Sore throat is a common complication after general anesthesia. Oral care solutions have been used to reduce the incidence of oral complications or ventilator-associated pneumonia, but their effect on postoperative sore throat (POST) is unclear. This study aims to investigate whether oral care solution can alleviate POST in patients undergoing i-gel laryngeal mask general anesthesia. Methods: A total of 120 patients who were scheduled for elective surgery under laryngeal mask general anesthesia were enrolled. The patients were randomly assigned to an experimental group (oral care solution) and a control group (0.9% saline) and gargled for 1 min with 10mL of oral care solution or saline 5 min before anesthesia induction. The primary outcomes were the overall incidence of sore throat within 24 h and incidence at 20 min, 1 h, 6 h, 24 h after removal of i-gel. The secondary outcomes were the severity of sore throat at the four time points and incidence of hoarseness, cough within 24 h after removal of i-gel. Results: A total of 111 patients were included in the analysis. The overall incidence of sore throat within 24 h in the experimental group was significantly lower than that in the control group, as was the incidence at four time points (P<0.05). The VAS scores at the four time points in the experimental group were significantly lower than those in the control group (P<0.05), and the results of repeated measurement analysis of variance showed that time effect and intergroup effect were statistically significant (P<0.001). No differences were found between the groups in the incidence of hoarseness and cough. Conclusion: Gargling with oral care solution before anesthesia induction can significantly reduce the incidence and severity of POST in patients undergoing i-gel laryngeal mask general anesthesia.

Remifentanil requirement for i-gel insertion is reduced in male patients with Parkinson's disease undergoing deep brain stimulator implantation: an up-and-down sequential allocation trial.

BACKGROUND: Laryngeal mask airways have been widely used in clinical practice. The aim of this study was to investigate whether the remifentanil requirement for facilitation of i-gel insertion in Parkinson's disease (PD) patients undergoing deep brain stimulation (DBS) surgery was different from that in non-PD (NPD) patients undergoing intracranial surgery. STUDY DESIGN: An up-and-down sequential allocation trial. METHODS: Male patients aged between 40 and 64 years old were enrolled. The first patient in each group (PD and NPD) group received an effect-site concentration (Ce) of remifentanil (Minto pharmacokinetic model) of 4.0 ng.ml-1 during a target-controlled infusion (TCI) of 3.5 µg.ml-1 propofol (Marsh pharmacokinetic model). The next dose of remifentanil was determined by the response of the previous patient. The Ce of remifentanil required for i-gel insertion in 50% of patients (EC50) was estimated by the modified Dixon's up-and-down method and by probit analysis. RESULTS: The PD group included 24 patients and the NPD group included 23. The EC50 of remifentanil for i-gel insertion during a TCI of 3.5 µg.ml-1 propofol estimated by the modified Dixon's up-and-down method in PD patients (2.38 ± 0.65 ng.ml-1) was significantly lower than in NPD patients (3.21 ± 0.49 ng.ml-1) (P = 0.03). From the probit analysis, the EC50 and EC95 (effective Ce in 95% of patients) of remifentanil were 1.95 (95% CI 1.52-2.36) ng.ml-1 and 3.12 (95% CI 2.53-5.84) ng.ml-1 in PD patients and 2.85 (95% CI 2.26-3.41) ng.ml-1 and 4.57 (95% CI 3.72-8.54) ng.ml-1 in NPD patients, respectively. CONCLUSIONS: The remifentanil requirement for successful i-gel insertion is reduced in male PD patients undergoing DBS implantation during propofol TCI induction. Clinicians should closely monitor the remifentanil requirement in patients with PD. TRIAL REGISTRATION: Registered at http://www.chictr.org.cn ( ChiCTR1900021760 ).

The duration of chronic low back pain is associated with acute postoperative pain intensity in lumbar fusion surgery: a prospective observational study.

BACKGROUND: Pre-existing chronic pain has been associated with severe postoperative pain. In this study, we sought to prospectively analyse the association between the duration of chronic low back pain and the intensity of acute postoperative pain after lumbar fusion surgery. METHODS: A total of 330 patients who underwent lumbar fusion surgery were divided into three groups (chronic low back pain less than 1 year, one to 5 years, and more than 5 years) based on the duration of chronic pain. On the first postoperative day, the maximum pain scores of each patient were recorded during the day and at night. Bivariate correlation and logistic regression were performed to identify relationships between acute postoperative pain and related variables (age, sex, smoking history, body mass index, operation history, duration of surgery, level of preoperative pain, aetiology of back pain, Self-rating Anxiety Scale, Self-rating Depression Scale, FRAIL scale, and duration of chronic low back pain). If the postoperative pain score was > 3 when the patient reported was at rest, the patients were treated with postoperative intravenous self-controlled analgesia or rescue analgesics if necessary. RESULTS: There was an association between severe acute postoperative pain and the duration of chronic low back pain. In terms of VAS day, multivariable logistic regression showed the duration of chronic low back pain was not statistically significant (OR = 2.48, 95% CI: 0.900 to 6.828, p = 0.0789). The result is uncertain because the confidence interval included the null after controlling for SAS, SDS, BMI, and aetiology of back pain. In terms of VAS night, patients with a duration of chronic low back pain of more than 5 years were more likely having moderate to severe acute postoperative pain (VAS > 3) compared to patients with a duration of chronic low back pain less than 1 year (OR = 3.546, 95% CI: 1.405 to 8.95, p = 0.0074). Hospital stay, the pain score on the day of discharge and the pain score after 3 months displayed no significant difference among the three groups (P > 0.05). However, the need for postoperative rescue analgesics was different among the three groups (P < 0.05). CONCLUSION: The longer the duration of chronic pain was, the higher the incidence of moderate to severe acute postoperative pain was and the greater the amount of analgesics required after surgery. TRIAL REGISTRATION: This study was registered at the Chinese Clinical Trial Registration Center ( http://www.chictr.org.cn/index.aspx , clinical trial number: ChiECRCT20200165, date of registration: July 6, 2020).

Simultaneous measurement of H2O concentration and effective absorption optical path length under unknown optical path length condition based on a single spectral line.

Quantitative gas measurement under the condition of unknown optical path length is a challenge in laser absorption spectroscopy technology field. In this paper, we proposed a tunable diode laser absorption spectroscopy line shape analysis (TDLAS-LSA) method for simultaneous measurement of water vapor concentration and effective optical path length (EOPL) under unknown optical path conditions. A single H2O absorption line near 1383.9 nm (7226.02 cm-1) was selected, and its line strength, self-broadening coefficient and temperature-dependence coefficient were measured experimentally to improve the HITRAN databases. The Lorentz broadening and line area were accurately extracted by Hartmann-Tran profile (HTP) fitting, and the gas concentration and EOPL were calculated based on the spectral line shape analysis method. Eight concentrations of water vapor in the range of 146 ppm âˆ¼ 4.39% were measured experimentally, and the maximum average deviation between the TDLAS-LSA method and the commercial sensor was less than 7.1%. Comparing the EOPL with mechanical measurement, the maximum deviation of multiple measurements is less than 5.7%. The results showed that the TDLAS-LSA method can effectively perform gas sensing under unknown optical path conditions, and has great application potential in low-cost, in-situ and multi-parameter simultaneous measurement.

Minimum Alveolar Concentration-Awake of Sevoflurane is Decreased in Patients with Parkinson's Disease: An Up-and-Down Sequential Allocation Trial.

BACKGROUND: An increasing number of patients with Parkinson's disease (PD) will have surgery under general anesthesia. A previous study demonstrated that propofol requirement for inducing unconsciousness in PD patients was lower than that in non-PD (NPD) patients. However, the requirement of inhaled anesthetics in PD patients has not been clarified. The aim of this study was to investigate the minimum alveolar concentration-awake (MACawake) of sevoflurane in patients with PD compared to NPD patients. PATIENTS AND METHODS: The current study is an up-and-down sequential allocation trial. The initial end-tidal concentration of sevoflurane (CETsevo) was estimated by the response of the previous patient to verbal command using the Dixon's up-and-down method. The first patient in each group received CETsevo at 1%, and the step size between patients was 0.2%. RESULTS: Forty-one patients including 20 PD patients and 21 NPD patients were enrolled. Patients' characteristics and arterial blood gas parameters (except blood sodium) were comparable between two groups. The MACawake of sevoflurane estimated by the Dixon's up-and-down method in PD patients (0.47% ± 0.08% [Mean ± S.D.]) was significantly lower than that in NDP patients (0.64% ± 0.10%) (P=0.003). The estimated difference in means was 0.17% (95% CI, 0.10-0.24%). Probit analysis showed that the MACawake of sevoflurane in PD and NPD patients was 0.49% (95% CI, 0.42-0.57%) and 0.67% (95% CI, 0.59-0.76%), respectively. The relative median potency was 0.73 (95% CI, 0.38-0.94). CONCLUSION: Patients with PD exhibit a significantly lower MACawake of sevoflurane compared with NPD patients. Clinicians should avoid an overdose of sevoflurane in patients with PD. TRIAL REGISTRATION: Registered at ChiCTR1900026956.

Temperature measurement with compositional correction of gas mixture based on laser-induced plasma.

Laser-induced breakdown plasma was used for gas temperature measurement based on the residual energy of a laser pulse defined as the laser energy detected in the beam path as well as plasma emissions. Gas mixtures with different compositions (O2/N2, O2/CO2, and O2/N2/CO2) were used to simulate the main components of combustion products at different temperatures. First, the correlation of residual energy and gas temperature was investigated, which showed that the residual energy increased with an increase in the gas temperature. The results showed that it also relates to the gas composition, which would affect the characteristics of laser-induced plasma. Then the spectral emission ratio of the plasma (O/N, O/C, and C/N) was obtained simultaneously to correct the compositional effect on the temperature measurement. Finally, the gas temperature with different components can be obtained by the equation coupled with the gas temperature, residual energy, and gas composition. The corrected temperature is consistent with that obtained by thermocouple and the gas temperature measurement error is less than 3.5% in the range from 309 K to 548 K.

Coal Discrimination Analysis Using Tandem Laser-Induced Breakdown Spectroscopy and Laser Ablation Inductively Coupled Plasma Time-of-Flight Mass Spectrometry.

The contribution and impact of combined laser ablation inductively coupled plasma time-of-flight mass spectrometry (LA-ICP-TOF-MS) and laser-induced breakdown spectroscopy (LIBS) were evaluated for the discrimination analysis of different coal samples. This tandem approach allows simultaneous determination of major and minor elements (C, H, Si, Ca, Al, Mg, etc.) and trace elements (V, Ba, Pb, U, etc.) in the coal. The research focused on coal-classification strategies based on principle component analysis (PCA) combined with K-means clustering, partial least-squares discrimination analysis (PLS-DA), and support vector machine (SVM) for analytical performance. Correlation analyses performed from TOF mass and LIBS emission spectra from the coal samples showed that most major, minor, and trace element emissions had negative correlation with the volatile content. Suitable variables for the classification models were determined from these data. The individual TOF data, LIBS data, and combined data of TOF and LIBS as the inputs for different models were analyzed and compared. In all cases, the results obtained with the combined TOF and LIBS data were found to be superior to those obtained with the individual TOF or LIBS data. The nonlinear SVM model combined with TOF and LIBS data provided the best coal-classification performance, with a classification accuracy of up to 98%.

A hybrid model combining wavelet transform and recursive feature elimination for running state evaluation of heat-resistant steel using laser-induced breakdown spectroscopy.

Heat-resistant steel is widely used in various industries, and the running state is of great importance for equipment function and safety. In this work, laser-induced breakdown spectroscopy (LIBS) is applied to evaluate the running state of steel using indicators of micro and macro properties. The hybrid model based on wavelet threshold denoising (WTD) and K-fold-support vector machine-recursive feature elimination (K-SVM-RFE) is proposed to estimate the different indictors of various service conditions of steel. Fourteen T91 specimens, including 4 industrial specimens obtained from different service conditions in the power plant boiler, were used as the analytes. Firstly, the noise signal of the LIBS spectra of each specimen was analyzed and removed with WTD. Secondly, an improved approach K-SVM-RFE was applied to select the optimal feature subset and build the classification models of aging grade and hardness grade. The influence of denoising pretreatment on model performance was compared and discussed. Finally, the assessment matrix, established using the indicators from the aging grade and hardness grade, was used to evaluate the running state of steel. The results show that the test assessment matrix obtained with the hybrid model based on WTD and K-SVM-RFE is consistent with the reference matrix on the running state of steel.

[A New Calibrated Model of Coal Calorific Value Detection with LIBS].

A set of coal samples were used for laser-induced breakdown spectroscopy (LIBS) experiment to measure the coal calorific value. Traditional channel normalization method didn't consider the physical / chemical mechanism of coal, which would limit the model in precision, accuracy and repeatability. Thus a new calibrated model based on the kinds of the effects of spectral deviation was proposed in this paper. The model selected 19 groups of coal samples, where the random 15 groups were used to establish quantitative analysis model of calorific value while the remaining four for inspection and evaluation. The model based on spectral deviation factors, and the transmission theory combined with the stark broadening formula was used to deduce the absorption effect mechanism and the deviation correction method under the condition of LIBS. The mutual interference between elements and the mechanism of matrix effect were being analyzed while K coefficient method was used to correct mutual interference between the elements in the LIBS. The establishment of numerical model with the electron density, the plasma temperature and the element concentration was used to deeply corrected spectrum deviation caused by matrix effect. Thus taking into consideration of the effect of self-absorption, interfere of inter-elements and matrix effect, the calibration model was established, while R2=0.967, RMSEP=0.49 MJ·kg-1, RMSE=0.45 MJ·kg-1, MRE=2.42%, ARE=1.64%, RSD=5.79% and RSDP=8.10%. Compared with the 0.405, 8.28 MJ·kg-1, 4.14 MJ·kg-1, 22.85%, 52.48%, 18.28% and 32.85% of traditional channel normalized-multiple linear regression method, it demonstrated that the precision and accuracy have been improved significantly and model has good application value.

Liquid sampling-atmospheric pressure glow discharge as a secondary excitation source for laser ablation-generated aerosols: parametric dependence and robustness to particle loading.

Liquid sampling-atmospheric pressure glow discharge (LS-APGD) microplasma is being developed as a secondary vaporization-excitation source for the optical emission analysis of laser ablation (LA)-generated particle populations. The practicalities of this coupling are evaluated by determining the influence of source parameters on the emission response and the plasma's robustness upon LA introduction of easily ionized elements (EIEs). The influence of discharge current (45-70 mA), LA carrier gas flow rate (0.1-0.8 L min(-1)), and electrode separation distance (0.5-3.5 mm) was studied by measuring Cu emission lines after ablation of a brass sample. Best emission responses were observed for high-discharge currents, low He carrier gas flow rates, and relatively small (<1.5 mm) electrode gaps. Plasma robustness and spectroscopic matrix effects were studied by monitoring Mg(II) : Mg(I) intensity ratios and N2-derived plasma rotational temperatures after the ablation of Sr- and Ca-containing pellets. Plasma robustness investigations showed that the plasma is not appreciably affected by the particle loadings, with the microplasma being slightly more ionizing in the case of Ca introduction. In neither case did the concentration of the concomitant element change the robustness values, implying a high level of robustness. Introduction of the LA particles results in slight increases in the rotational temperatures (∼10% relative), with Ca-containing particles having a greater effect than Sr-containing particles. The observed variation of 9% in the plasma rotational temperature is in the same order of magnitude as the short-term reproducibility determined by the proposed LA-LS-APGD system. The determined rotational temperatures ranged from 1047 to 1212 K upon introducing various amounts of Ca and Sr. The relative immunity to LA particle-induced matrix effects is attributed to the relatively long residence times and high power densities (>10 W mm(-3)) of the LS-APGD microplasma.

Experimental study of laser-induced breakdown spectroscopy (LIBS) for direct analysis of coal particle flow.

Laser-induced breakdown spectroscopy (LIBS) was employed to directly analyze coal particles in the form of descending flow. Coal-particle ablation was performed using a 1064 nm neodymium-doped yttrium aluminum garnet (Nd : YAG) laser at atmospheric conditions. Spectral identification schemes were used to acquire spectra containing all the emission lines of the important elements in coal. These acquired spectra were classified as representative spectra. The background of the line emission plus three times the standard deviation of the background of the representative spectra was chosen as the threshold value. A method using a single line and a method using combined multiple lines (C, 247.8 nm; N, 746.8 nm; Si, 288.2 nm; and Ca, 396.8 nm) were compared to obtain the best results for the spectral identification of coal particle flow. The feasibility of rejecting the partial breakdown spectra was verified using quantitative analysis of fixed carbon in coal.

Carbon isotope separation and molecular formation in laser-induced plasmas by laser ablation molecular isotopic spectrometry.

Laser ablation molecular isotopic spectrometry (LAMIS) recently was reported for rapid isotopic analysis by measuring molecular emission from laser-induced plasmas at atmospheric pressure. This research utilized the LAMIS approach to study C2 molecular formation from laser ablation of carbon isotopic samples in a neon gas environment at 0.1 MPa. The isotopic shift for the Swan system of the C2 Δν = 1 band was chosen for carbon isotope analysis. Temporal and spatial resolved measurements of (12)C2, (12)C(13)C, and (13)C2 show that C2 forms from recombination reactions in the plasma. A theoretical simulation was used to determine the temperature from the molecular bands and to extract the isotopic ratio of (12)C/(13)C derived from (12)C2, (12)C(13)C, and (13)C2. Our data show that the ratio of (12)C/(13)C varies with time after the laser pulse and with distance above the sample. (12)C/(13)C deviates from the nominal ratio (2:1) at early times and closest to the sample surface. These measurements provide understanding of the chemical processes in the laser plasma and analytical improvement using LAMIS.

[The study on the laser-induced breakdown spectroscopy properties of compound fertilizer with different physical forms].

In order to study the mechanism of laser-induced breakdown spectroscopy for detecting the chemical components content of compound fertilizer in detail, two physical forms of compound fertilizer samples (powder and granular) were used for this study. The authors analyzed the laser-induced breakdown spectroscopy properties of samples with different physical forms made under different preparation pressure. And the spectral characteristics and plasma characteristics of N,P and K in the powder and granules made under the preparation pressure of 0, 0. 5, 2, 4, and 6 MPa, respectively were compared experimentally. The experiments results showed that the spectral characteristics of the two forms have obvious difference when the pressure is small and the grain samples have significant higher line intensity than those of the powder samples. With the increase in the pressure, the difference in the plasma characteristics between these two physical forms was reduced, and all the characteristic spectral lines intensity of the same physical form samples increases firstly and reduces afterward.

Extracting coal ash content from laser-induced breakdown spectroscopy (LIBS) spectra by multivariate analysis.

Laser-induced breakdown spectroscopy (LIBS) combined with partial least squares (PLS) analysis has been applied for the quantitative analysis of the ash content of coal in this paper. The multivariate analysis method was employed to extract coal ash content information from LIBS spectra rather than from the concentrations of the main ash-forming elements. In order to construct a rigorous partial least squares regression model and reduce the calculation time, different spectral range data were used to construct partial least squares regression models, and then the performances of these models were compared in terms of the correlation coefficients of calibration and validation and the root mean square errors of calibration and cross-validation. Afterwards, the prediction accuracy, reproducibility, and the limit of detection of the partial least squares regression model were validated with independent laser-induced breakdown spectroscopy measurements of four unknown samples. The results show that a good agreement is observed between the ash content provided by thermo-gravimetric analyzer and the LIBS measurements coupled to the PLS regression model for the unknown samples. The feasibility of extracting coal ash content from LIBS spectra is approved. It is also confirmed that this technique has good potential for quantitative analysis of the ash content of coal.

Experimental study on the characteristics of molecular emission spectroscopy for the analysis of solid materials containing C and N.

Solid materials with different structure containing C and N were analyzed by laser-induced breakdown spectroscopy (LIBS). Comparing the emission molecular species in different atmosphere (air and argon), it can be determined that whether the molecular species are directly vaporized from sample or generated through dissociation or the interaction between plasma and air molecules. The results showed that the characteristic of C2 bands emission is similar with that of neutral atomic carbon emission CI in different atmosphere (air and argon). While the characteristic of CN bands emission is more complicated and it has great relationship with the existence of CN radicals, the interaction between plasma and air ambient, and the recombination of excited partials.

[Application of wavelet transform in laser-induced breakdown spectra compression].

A method based on the wavelet transform (WT) was developed for the compression of laser-induced breakdown coal spectral data. By studing the impacts of main parameters such as the order of db wavelet, decompose level and threshold method on compression performance, it can summarize the compression parameter selection rule and select the proper compression scheme. The scheme was evaluated by compression scores and relative deviation of each spectral line between original and reconstructed. By choosing proper parameters for channel 1, channel 2 and channel 5 of LIBS spectrum of coal sample (No. 1-No. 8), the restore score RS and compress score CS are respectively 81%-92.11% and 79.02%-92.07%, with the spectral line relative deviation under 5%. It indicates that the storage space is reduced while the main characteristic of original spectrum is maintained. The result shows that this method is very effective.