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BackgroundHydrogen sulfide is a highly toxic, flammable, and colorless gas. Hydrogen sulfide has been identified as a potential terrorist chemical threat agent in mass-casualty events. Our previous studies showed that cobinamide, a vitamin B12 analog, effectively reverses the toxicity from hydrogen sulfide poisoning. In this study, we investigate the effectiveness of intratracheally administered cobinamide in treating a lethal dose hydrogen sulfide gas inhalation and compare its performance to saline control administration.MethodsA total of 53 pathogen-free New Zealand White rabbits were used for this study. Four groups were compared: (i) received no saline solution or drug intratracheally (n = 15), (ii) slow drip saline intratracheally (n = 15), (iii) fast drip saline intratracheally (n = 15), and (iv) slow drip cobinamide intratracheally (n = 8). Blood pressure was continuously monitored, and deoxy- and oxyhemoglobin concentration changes were monitored in real-time in vivo using continuous wave near-infrared spectroscopy.ResultsThe mean (± standard deviation) weight for all animals (n = 53) was 3.87 ± 0.10 kg. The survival rates of the slow cobinamide and the fast saline groups were 75 percent and 60 percent, respectively, while the survival rates in the slow saline and control groups were 26.7 percent and 20 percent, respectively. A log-rank (Mantel-Cox) test showed that survival in fast saline and slow cobinamide groups were significantly greater than those of no saline control and slow saline groups (P

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

INTRODUCTION: Therapeutic approaches to varicose veins include sclerotherapy, laser ablation, and surgery. Using sclerosing agents such as hypertonic saline, polidocanol, and glycerol can be an option in cases of recurrent varicose veins. This study aimed to assess the effectiveness of hypertonic saline, polidocanol, and glycerol as sclerosant agents in an in vivo study. MATERIAL AND METHODS: This was an experimental study on 24 Javan rabbits, divided into three treatment groups: hypertonic saline (group I, n=8), polidocanol (group II, n=8), and glycerol (group III, n=8). All animals received treatment by injection into the vein behind the ear, then vein damming 10 minutes later. Punch tissue samples for standard histopathological examination were taken from blood vessels at 1 hour, 24 hours, 7 days, and 45 days posttreatment across all groups. The histopathology changes were scored based on inflammation, proliferation, luminal narrowing, and fibrosis. RESULT: No differences were observed in the degrees of inflammation, proliferation, luminal narrowing, or fibrosis at different observation intervals. However, a significant and positive correlation was found between inflammation, vascular proliferation, and fibrosis with all sclerosing agents (p<0.005). No significant correlation exists in the scoring of luminal narrowing among any sclerosing agent (p>0.005). CONCLUSION: Hypertonic saline, polidocanol, and glycerol demonstrated comparable efficacy as sclerosing agents in vivo concerning fibrosis, vascular proliferation, and inflammation. [ABSTRACT FROM AUTHOR]

Objective To determine the effects of Dextrose 5% for maintenance and creep fluids on cumulative fluid balance (CFB) for septic shock concerning adult people.Design An open-label randomized clinical trial with a single center and parallel groups.Setting ICUs of a tertiary care academic medical center.Patients Adult individuals who have developed septic shock as described by the Sepsis 3 criteria.Interventions Dextrose 5% (n = 50) versus Saline 0.9% (n = 50) for maintenance and creep fluid for 72 hours.Main variables of interest The primary outcome measured was the CFB at 72 hours. Secondary outcomes assessed included mortality within 28 days, the number of days patients were free from (coma and delirium, ICU, mechanical ventilation, vasopressors), the occurrence of acute kidney injury, and disturbances in electrolyte levels.Results The CFB was significantly lower in Dextrose group vs Saline group (4.46 versus 6.75 L, median difference; −2.06 L; 95% CI, −2.63 to −1.35; p = P

Purpose: To investigate the relationship between urine cytology results after overnight continuous saline irrigation (OCSI) following transurethral resection of bladder tumor (TURBT) and bladder tumor recurrence in non-muscle invasive bladder cancer (NMIBC). Materials and Methods: A retrospective study was conducted on patients diagnosed with NMIBC between 2016 and 2020 after undergoing TURBT at our hospital. All patients received OCSI following TURBT and had urine cytology test at postoperative 1 day. Urine cytology was classified into three groups: Negative, low-grade urothelial neoplasm (LGUN)+atypical urothelial cells (AUC), and suspicious for high-grade urothelial carcinoma (SHGUC)+high-grade urothelial carcinoma (HGUC). Recurrence-free survival (RFS) in each group was compared using the Kaplan–Meier method. Univariable and multivariable Cox regression analyses were performed to evaluate independent prognostic factors. Results: A total of 172 patients were included in this study. Based on urine cytology group (after OCSI), RFS did not reach the median value in the Negative group. In the LGUN+AUC group, the median RFS was 615.00 days. In the SHGUC+HGUC group, the median RFS was 377.00 days. In survival analysis, the Negative group had a longer RFS than the SHGUC+HGUC group (p=0.013). However, Cox regression analysis showed that SHGUC+HGUC was not an independent prognostic factor for recurrence. Conclusions: Urine cytology results after OCSI following TURBT in NMIBC were associated with bladder tumor recurrence. Specifically, SHGUC or HGUC in urine cytology after OCSI showed earlier recurrence than negative cases. However, further research is needed to accurately determine whether it is an independent prognostic factor.

BACKGROUND: Irrigated radiofrequency ablation with half-normal saline can potentially increase lesion size but may increase the risk of steam pops with the risk of emboli or perforation. We hypothesized that pops would be preceded by intracardiac echocardiography (ICE) findings as well as a large impedance fall. METHODS: In 100 consecutive patients undergoing endocardial ventricular arrhythmia radiofrequency ablation with half-normal saline, we attempted to observe the ablation site with ICE. Radiofrequency ablation power was titrated to a 15 to 20 Ohm impedance fall and could be adjusted for tissue whitening and increasing bubble formation on ICE. Steam pops were defined as audible or a sudden explosion of microbubbles on ICE. RESULTS: Of 2190 ablation applications in 100 patients (82% cardiomyopathy, 50% sustained ventricular tachycardia), pops occurred during 43 (2.0%) applications. Sites with pops had greater impedance decreases of 18 [14, 21]% versus 13 [10, 17]% (P<0.001). ICE visualized 1308 (59.7%) radiofrequency sites, and fewer pops occurred when ICE visualized the radiofrequency ablation site (1.4%) compared with without ICE visualization (2.8%; P=0.016). Of the 18 ICE-visible pops, 7 (39%) were silent but recognized as an explosion of bubbles on ICE. With ICE, 89% of pops were preceded by either tissue whitening or a sudden increase in bubbles. In a multivariable model, tissue whitening and a sudden increase in bubbles were associated with steam pops (odds ratio, 7.186; P=0.004, and odds ratio, 29.93; P<0.001, respectively), independent of impedance fall and power. There were no pericardial effusions or embolic events with steam pops. CONCLUSIONS: Steam pops occurred in 2% of half-normal saline radiofrequency applications titrated to an impedance fall and are likely under-recognized without ICE. On ICE, steam pops are usually preceded by tissue whitening or a sudden increase in bubble formation, which can potentially be used to adjust radiofrequency application to help reduce pops. [ABSTRACT FROM AUTHOR]

Objective: To investigate epidermal growth factor, transforming growth factor-α and interleukin-8 production in nasal mucosa irrigated with hypertonic 2.3 per cent solution with algae extracts, in comparison to 0.9 per cent NaCl during the first two weeks after surgery for nasal polyposis, in relation to symptoms and local findings. Methods: This prospective study included 20 nasal polyposis patients postoperatively irrigated with hypertonic solution and 20 nasal polyposis patients postoperatively irrigated with isotonic solution. We evaluated nasal symptom score, endoscopic score and mediator levels in nasal secretions before and after irrigation. Results: Following treatment, nasal symptom score and endoscopic score were significantly lower in the hypertonic solution group (p = 0.023; p < 0.001, respectively). The increase in the epidermal growth factor and the decrease in the transforming growth factor-α and interleukin-8 concentration were higher in the hypertonic group (p < 0.001 for all mediators). Conclusion: Irrigation with a hypertonic solution was found to be more effective than an isotonic solution in nasal mucosa reparation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Open respiratory secretion suctioning with a catheter causes pain and tracheobronchial mucosal injury in intubated patients. The goal of mechanical insufflation-exsufflation (MI-E) is to move secretions proximally and noninvasively by generating a high peak expiratory air flow. Nebulized hypertonic saline with hyaluronic acid (HS-HA) may facilitate suctioning by hydration. We assessed the safety and tolerance of a single session of airway clearance with MI-E and HS-HA in critically ill intubated patients. METHODS: Adults with a cuffed artificial airway were randomized to (1) open suctioning, (2) open suctioning after HS-HA, (3) MI-E, or (4) MI-E with HS-HA. Adverse events, pain and sedation/agitation scores, and respiratory and hemodynamic variables were collected before, during, and 5-min and 60-min post intervention. RESULTS: One-hundred twenty subjects were enrolled and completed the study. Median (interquartile range [IQR]) Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 22 (16--28); median (IQR) age was 69.0 (57.0--75.7) y, and 90 (75%) were male. Baseline respiratory and hemodynamic variables were comparable. Adverse events occurred in 30 subjects (25%), with no between-group differences. Behavioral pain equivalents and Richmond Agitation-Sedation Scale were higher during suctioning in groups 1 (P < .001) and 2 (P < .001). Independent predictive variables for higher pain and agitation/sedation scores were study groups 1 and 2 and simultaneous analgosedation, respectively. Noradrenaline infusion rates were lower at 60 min in groups 2 and 4. PaO2/FIO2 had decreased at 5 min after open suctioning in group 1 and increased at 60 min in group 3. CONCLUSIONS: We observed no difference in adverse events. MI-E avoids pain and agitation. [ABSTRACT FROM AUTHOR]

High voltage silicone insulators that are placed close to coastal marine areas have the problem of salt fog depositing on their surfaces in the form of conductive droplets. Under the influence of an electric field, those droplets initiate partial discharges, which leads to the degradation of the hydrophobic properties of silicone rubber. This phenomenon, in which droplets serve as the cause of partial discharges, has been studied in considerable detail elsewhere. However, it remains unclear whether the droplets themselves, as moisture-laden areas, affect the properties of silicone rubber. The current work is focused on studying the combined effect of an AC electric field (E = 17 kV/cm) and a 4% solution of sodium chloride on the water-repellent properties of silicone rubber in the absence of electrical discharges. The results of the study show that the influence of moisture and an electric field leads to slowing down the droplet runoff from the inclined sample of Powersil 310 rubber. An AC electric field did not have a noticeable effect on the rate of water runoff; the slowdown was due to the pre-treatment of the sample with the solution. [ABSTRACT FROM AUTHOR]

BACKGROUND: Reducing treatment burden is a priority for people with cystic fibrosis, whose health has benefited from using new modulators that substantially increase CFTR protein function. The SIMPLIFY study aimed to assess the effects of discontinuing nebulised hypertonic saline or dornase alfa in individuals using the CFTR modulator elexacaftor plus tezacaftor plus ivacaftor (ETI). METHODS: The SIMPLIFY study included two parallel, multicentre, open-label, randomised, controlled, non-inferiority trials at 80 participating clinics across the USA in the Cystic Fibrosis Therapeutics Development Network. We included individuals with cystic fibrosis aged 12-17 years with percent predicted FEV1 (ppFEV1) of 70% or more, or those aged 18 years or older with ppFEV1 of 60% or more, if they had been taking ETI and either (or both) mucoactive therapies (≥3% hypertonic saline or dornase alfa) for at least 90 days before screening. Participants on both hypertonic saline and dornase alfa were randomly assigned to one of the two trials, and those on a single therapy were assigned to the applicable trial. All participants were then randomly assigned 1:1 to continue or discontinue therapy for 6 weeks using permuted blocks of varying size, stratified by baseline ppFEV1 (week 0; ≥90% or

Abstract Objectives/Hypothesis To assess the efficacy of 0.23% povidone-iodine (PVP-I) nasal rinses and mouth washes on detectability of the coronavirus disease 2019 (COVID-19) virus and cycle threshold (Ct) values in nasopharyngeal swabs. Study design This was an open-label, prospective, randomized, placebo-controlled clinical trial. Setting The study was conducted in King Saud University Medical City, Riyadh, Saudi Arabia, from August 2021 to July 2022. Methods Participants diagnosed with SARS-CoV-2 were randomly assigned to one of three groups, with participants receiving either 0.23% PVP-I, 0.9% normal saline (NS) nasal rinses and mouth washes, or no intervention (control group). Nasopharyngeal swabs were taken 4, 8, 12, and 18 days after the first swab to measure the detectability of the virus and the Ct. Results A total of 19 participants were involved in this study. The mean viral survival was 9.8, 12, and 12.6 days for the PVP-I, NS, and control groups, respectively, with a statistically significant difference (p = 0.046). The Ct mean values were 23 ± 3.4, 23.5 ± 6.3, and 26.3 ± 5.9 at the time of recruitment and 25.2 ± 3.5, 15 ± 11.7, and 26.9 ± 6.4 after 4 days for the PVP-I, NS, and control groups, respectively. Conclusions When used continuously at a concentration of 0.23%, PVP-I showed promising results in terms of decreasing the pandemic burden by reducing the period of infectiousness and viral load. However, the use of PVP-I did not result in significantly different changes in the quality-of-life parameters in recently vaccinated and mild COVID-19 patients.

Abstract A semi-industrial demineralization facility was used in six CDI cells to desalinate in two steps. A desalination cycle lowered the feedwater salinity from 1 to 0.5 g/L and produced 200 l/h of demineralized water. This process may be repeated to increase efficiency. Initially, feedwater commenced at 1 g/L. Monitoring both voltage and current during the salt ion removal indicated that CDI cells may recover 30% of the energy utilized. Furthermore, V–Q curves using charge and voltage measurements increased energy recovery by 30%. By cutting off the CDI cells' power source, the electrodes' operating voltage was recorded between 0.85 and 0.9 V, much lower than the external contacts' 1.2 V. The desalination system's efficiency could rise if the electrode voltage was measured and adjusted. In conclusion, storage tanks can provide desalinated water while minimizing water waste; hence, they should be installed. This study examined the physical–technical parameters of a CDI desalination system through experiments and several operational modes. Moreover, it revealed CDI desalination system improvements.

Objectives/Hypothesis: To assess the efficacy of 0.23% povidone-iodine (PVP-I) nasal rinses and mouth washes on detectability of the coronavirus disease 2019 (COVID-19) virus and cycle threshold (Ct) values in nasopharyngeal swabs. Study design: This was an open-label, prospective, randomized, placebo-controlled clinical trial. Setting: The study was conducted in King Saud University Medical City, Riyadh, Saudi Arabia, from August 2021 to July 2022. Methods: Participants diagnosed with SARS-CoV-2 were randomly assigned to one of three groups, with participants receiving either 0.23% PVP-I, 0.9% normal saline (NS) nasal rinses and mouth washes, or no intervention (control group). Nasopharyngeal swabs were taken 4, 8, 12, and 18 days after the first swab to measure the detectability of the virus and the Ct. Results: A total of 19 participants were involved in this study. The mean viral survival was 9.8, 12, and 12.6 days for the PVP-I, NS, and control groups, respectively, with a statistically significant difference (p = 0.046). The Ct mean values were 23 ± 3.4, 23.5 ± 6.3, and 26.3 ± 5.9 at the time of recruitment and 25.2 ± 3.5, 15 ± 11.7, and 26.9 ± 6.4 after 4 days for the PVP-I, NS, and control groups, respectively. Conclusions: When used continuously at a concentration of 0.23%, PVP-I showed promising results in terms of decreasing the pandemic burden by reducing the period of infectiousness and viral load. However, the use of PVP-I did not result in significantly different changes in the quality-of-life parameters in recently vaccinated and mild COVID-19 patients. [ABSTRACT FROM AUTHOR]

A semi-industrial demineralization facility was used in six CDI cells to desalinate in two steps. A desalination cycle lowered the feedwater salinity from 1 to 0.5 g/L and produced 200 l/h of demineralized water. This process may be repeated to increase efficiency. Initially, feedwater commenced at 1 g/L. Monitoring both voltage and current during the salt ion removal indicated that CDI cells may recover 30% of the energy utilized. Furthermore, V–Q curves using charge and voltage measurements increased energy recovery by 30%. By cutting off the CDI cells' power source, the electrodes' operating voltage was recorded between 0.85 and 0.9 V, much lower than the external contacts' 1.2 V. The desalination system's efficiency could rise if the electrode voltage was measured and adjusted. In conclusion, storage tanks can provide desalinated water while minimizing water waste; hence, they should be installed. This study examined the physical–technical parameters of a CDI desalination system through experiments and several operational modes. Moreover, it revealed CDI desalination system improvements. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the germination behavior and to define the initial vigor of maize seeds. Methodology: The genetic material consisted of four batches of 20 hybrid seeds each (M-2014, SR-2014, SR-2012, and SR-2011), which were germinated in a NaCl solution (0, 5, 10, and 15 dS m-1) in a germination chamber. A randomized complete block experimental design was used, in which the seed batch and salinity level were the experimental units, with four repetitions each. Seeds with defined radicle and plumule were counted for evaluation. Results: As a result of the comparison of the three batches from the same environment (production site) and different years, the statistical analysis indicated that the longest-lived seeds have a lower germination percentage. Similarly, when batches from different production environments and the same year were compared, M-2014 obtained the highest average germination percentage (92.19%). When the maximum level of salinity (15 dS m-1) was evaluated, an average 41.25% loss in germination was observed. Conclusions: The test efficiently discriminated seed batches, based on speed and uniformity in NaCl-based germination, therefore providing acceptable results for the evaluation of the viability and vigor of a seed batch. [ABSTRACT FROM AUTHOR]

ImportanceDelayed graft function (DGF) is a risk factor for acute rejection and graft failure after kidney transplant. Previous studies have suggested that dexmedetomidine may be renoprotective, but whether the use of dexmedetomidine would improve kidney allograft function is unknown.ObjectiveTo investigate the effects of perioperative dexmedetomidine on DGF following a donation-after-cardiac-death (DCD) kidney transplant.Design, setting, and participantsThis single-center, double-blind, placebo-controlled randomized clinical trial was conducted at The First Affiliated Hospital of Soochow University in Suzhou, China. Adults (18 years or older) who were scheduled for DCD kidney transplant were enrolled between September 1, 2019, and January 28, 2021, and then randomized to receive either dexmedetomidine or normal saline (placebo). One-year postoperative outcomes were recorded. All analyses were based on the modified intention-to-treat population.InterventionsPatients who were randomized to the dexmedetomidine group received a 24-hour perioperative dexmedetomidine intravenous infusion (0.4 μg/kg/h intraoperatively and 0.1 μg/kg/h postoperatively). Patients who were randomized to the normal saline group received an intravenous infusion of the placebo with the same dose regimen as the dexmedetomidine.Main outcomes and measuresThe primary outcome was the incidence of DGF, defined as the need for dialysis in the first posttransplant week. The prespecified secondary outcomes were in-hospital repeated dialysis in the first posttransplant week, in-hospital acute rejection, and serum creatinine, serum cystatin C, estimated glomerular filtration rate, need for dialysis, and patient survival on posttransplant day 30.ResultsOf the 114 patients enrolled, 111 completed the study (mean [SD] age, 43.4 [10.8] years; 64 male patients [57.7%]), of whom 56 were randomized to the dexmedetomidine group and 55 to the normal saline group. Dexmedetomidine infusion compared with normal saline reduced the incidence of DGF (17.9% vs 34.5%; odds ratio [OR], 0.41; 95% CI, 0.17-0.98; P = .04) and repeated dialysis (12.5% vs 30.9%; OR, 0.32; 95% CI, 0.13-0.88; P = .02, which was not statistically significant after multiple testing corrections), without significant effect on other secondary outcomes. Dexmedetomidine vs normal saline infusion led to a higher median (IQR) creatinine clearance rate on postoperative days 1 (9.9 [4.9-21.2] mL/min vs 7.9 [2.0-10.4] mL/min) and 2 (29.6 [9.7-67.4] mL/min vs 14.6 [3.8-45.1] mL/min) as well as increased median (IQR) urine output on postoperative days 2 (106.5 [66.3-175.6] mL/h vs 82.9 [27.1-141.9] mL/h) and 7 (126.1 [98.0-151.3] mL/h vs 107.0 [82.5-137.5] mL/h) and at hospital discharge discharge (110.4 [92.8-121.9] mL/h vs 97.1 [77.5-113.8] mL/h). Three patients (5.5%) from the normal saline group developed allograft failure by the post hoc 1-year follow-up visit.Conclusions and relevanceThis randomized clinical trial found that 24-hour perioperative dexmedetomidine decreased the incidence of DGF after DCD kidney transplant. The findings support the use of dexmedetomidine in kidney transplants.Trial registrationChinese Clinical Trial Registry Identifier: ChiCTR1900025493.

ObjectivesTo determine the frequency and characteristics of complications of peripherally administered hypertonic saline (HTS) through assessment of infiltration and extravasation.DesignRetrospective cross-sectional study.SettingFreestanding tertiary care pediatric hospital.PatientsChildren who received HTS through a peripheral IV catheter (PIVC).InterventionsNone.Measurements and main resultsWe conducted a single-center retrospective review from January 2012 to 2019. A total of 526 patients with 1,020 unique administrations of HTS through a PIVC met inclusion criteria. The primary endpoint was PIVC failure due to infiltration or extravasation. The indication for the administration of HTS infusion was collected. Catheter data was captured, including the setting of catheter placement, anatomical location on the patient, gauge size, length of time from catheter insertion to HTS infusion, in situ duration of catheter lifespan, and removal rationale. The administration data for HTS was reviewed and included volume of administration, bolus versus continuous infusion, infusion rate, infusion duration, and vesicant medications administered through the PIVC. There were 843 bolus infusions of HTS and 172 continuous infusions. Of the bolus administrations, there were eight infiltrations (0.9%). The continuous infusion group had 13 infiltrations (7.6%). There were no extravasations in either group, and no patients required medical therapy or intervention by the wound care or plastic surgery teams. There was no significant morbidity attributed to HTS administration in either group.ConclusionsHTS administered through a PIVC infrequently infiltrates in critically ill pediatric patients. The infiltration rate was low when HTS is administered as a bolus but higher when given as a continuous infusion. However, no patient suffered an extravasation injury or long-term morbidity from any infiltration.

With the rapid development of industry, how to reduce the amount of high-salt wastewater has become a serious environmental problem that needs to be solved urgently. Among various processes for treating high-salt wastewater, thermal evaporation technology has been widely used due to its good desalination effect and flexibility. In this paper, from the microscopic point of view, the evaporation processes of LiCl, KCl and CaCl2 solutions under heating conditions of 400 K and 500 K were studied by molecular dynamics simulation method, and the effects of four salt ions on the evaporation rates, water molecule orientation, hydrogen bond, solution structure and other properties were analyzed. It is shown that the increase of temperature will have a great influence on the evaporation rate, and will not change the position of the coordination hydration layer, but will obviously reduce the number of coordination water molecules of the ions, which will increase the proportion of active water molecules and evaporation rate. [ABSTRACT FROM AUTHOR]

Considering the relevance of Inconel 718 alloy for the oil and gas industry and the nature of the tribological system to define the friction and wear behaviors during sliding, this investigation presents results obtained in reciprocating tests under saline solution for active-screen plasma-nitrided Inconel 718. Bearing steel and silicon nitride ceramic were used as counterbodies, balls of 4 mm diameter. Extensive plastic deformation was confirmed using nanoindentation analysis, and oxidation governed the tribological responses when the steel ball was used as a counterbody. In these conditions, the presence of a nitrided layer was significant in reducing wear by one order of magnitude. On the other hand, when the ceramic ball was tested, abrasive wear was the primary mechanism, and the nitrided layer did not affect either the friction or the wear rate of Inconel 718. The corrosion behavior helped to confirm the predominance of described wear mechanisms. [ABSTRACT FROM AUTHOR]

Copyright of Inorganic Chemicals Industry is the property of Editorial Office of Inorganic Chemicals Industry and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Electronic Processing of Materials / Elektronnaya Obrabotka Materialov is the property of Institute of Applied Physics and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

INTRODUCTION: The role of submucosal injection during cold snare polypectomy (CSP) remains uncertain. In this study, we investigated the impact of submucosal saline injection during CSP for colorectal polyps sized 3-9 mm. METHODS: This was a multicenter randomized controlled trial conducted in 6 Chinese centers between July and September 2020 (ChiCTR2000034423). Patients with nonpedunculated colorectal polyps sized 3-9 mm were randomized in a 1:1 ratio to either CSP with submucosal injection (SI-CSP) or conventional CSP (C-CSP). The primary outcome was the incomplete resection rate (IRR). Secondary outcomes included procedure time, intraprocedural bleeding, delayed bleeding, and perforation. RESULTS: One hundred fifty patients with 234 polyps in the SI-CSP group and 150 patients with 216 polyps in the C-CSP group were included in the analysis. The IRR was not decreased in the SI-CSP group compared with that in the C-CSP group (1.7% vs 1.4%, P 51.000). The median procedure time in the SI-CSP group was significantly longer than that in the C-CSP group (108 seconds vs 48 seconds, P < 0.001). The incidences of intraprocedural bleeding and delayed bleeding were not significantly different between the 2 groups (P 5 0.531 and P 5 0.250, respectively). There was no perforation in either group. DISCUSSION: Submucosal saline injection during CSP for colorectal polyps sized 3-9mmdid not decrease the IRR or reduce adverse events but prolonged the procedure time. [ABSTRACT FROM AUTHOR]

Kaolin is a common clay in engineering. The microstructure of kaolin is very sensitive to the change of pore environment. At present, the research on the relationship between pore environment characteristics and acoustic wave velocity of kaolin remains to be further studied. In this paper, based on the ultrasonic test theory, RSM-SY6 ultrasonic detector is used to study the change rule of ultrasonic wave velocity of kaolin under different pore environment conditions. In addition, the influence mechanism of pore environment characteristics on ultrasonic wave velocity of kaolin is analyzed from the microscopic perspective of the arrangement mode of clay particles and the interaction between clay particles and pore solution. The results show that (1) the ultrasonic wave velocity of kaolin decreases with the increasing void ratio. (2) With the increasing water content, the ultrasonic wave velocity of kaolin decreases slightly at first and then increases greatly. (3) The effect of pore solution pH value on ultrasonic wave velocity of kaolin is related to the edge isoelectric pH value. When the pore solution pH value is equal to the edge isoelectric pH value, the ultrasonic wave velocity is the maximum. (4) The addition of salt reduces the ultrasonic wave velocity of kaolin. When the concentration of saline solution ranges from 0 to 0.5 mol/L, the wave velocity decreases rapidly. Under the same anion condition, the high valence cation has a more obvious effect on the reduction of ultrasonic wave velocity. This paper provides a reference for the study of the acoustic characteristics of viscous soil, and also provides a theoretical basis for the application of ultrasonic detection technology in soil.

Background/aimsDespite evidence that preferential use of balanced/buffered fluids may improve outcomes compared with chloride-rich 0.9% saline, saline remains the most commonly used fluid for children with septic shock. We aim to determine if resuscitation with balanced/buffered fluids as part of usual care will improve outcomes, in part through reduced kidney injury and without an increase in adverse effects, compared to 0.9% saline for children with septic shock.MethodsThe Pragmatic Pediatric Trial of Balanced versus Normal Saline Fluid in Sepsis (PRoMPT BOLUS) study is an international, open-label pragmatic interventional trial being conducted at > 40 sites in the USA, Canada, and Australia/New Zealand starting on August 25, 2020, and continuing for 5 years. Children > 6 months to

Interface bonding between calcium silicate hydrate (C–S–H) and epoxy is of critical importance for C–S–H/epoxy composites that are extensively utilized in the civil engineering, and yet it is susceptible to saline solution or elevated temperature. Herein, molecular dynamics is applied to explore the debonding mechanisms of epoxy from C–S–H surface under the coupling effect of water, ions, and temperature. Aqueous environment is the prerequisite for temperature and ions to influence interface bonding. At dry state, temperature elevation promotes the structure relaxation of C–S–H/epoxy interface, which optimizes the coordination structure at interface and increases interface energy. At wet state, on the contrary, temperature elevation aggravates the weakened effect of water molecules on interface bonding. The dynamics of epoxy molecules changes from the feature of solid state into fluid state. Water molecules and Na+ act in the same way at the interface. Both compete for active sites of epoxy molecules and C–S–H surface, which interferes the formation and stability of the bonds between C–S–H and epoxy molecules. As compared with water molecules, ions play larger roles in weakening interface bonding.

The Europa lander is a concept for a potential future planetary exploration mission which purpose is to characterize the icy shell of Europa and to search for organics. To achieve this objective, the current concept of the lander includes a Raman spectrometer, such as RLS instrument, that could be able to analyze (sub) surface targets in their solid and liquid form. Knowing that ice and brines of Europa are potentially enriched by sulfate and chlorides, this work seeks to evaluate if Raman spectroscopy could be used to semi quantify the saline content of water solutions using space‐like instrumentation. To do so, MgSO4 and MgCl2 were used to prepare three sets of water solutions. Raman analyses were then performed by the laboratory simulator of the ExoMars Raman Laser Spectrometer (RLS), which has been defined as the threshold system for the Europa Lander. After data analysis, two different semi‐quantification approaches were tested, and their results compared. Although univariate calibration curves proved to successfully quantify the content of SO42− and Cl− anions dissolved in mono‐analyte water solutions, this strategy provided very poor results when applied to binary saline mixtures. Overcoming this issue, the non‐linearity prediction ability of Artificial Neural Networks (ANNs) in combination with bandfitting allows to successfully resolve the complexity of the vibrational perturbation suffered by the OH region, which is caused by the cross interaction of H2O molecules with different anions. [ABSTRACT FROM AUTHOR]

The deterioration of reinforced concrete structures in marine environments presents multiple problems due to the premature degradation of reinforced steel. This work aimed to study the corrosion of reinforced A630-420H steel when exposed to a 0.5 M NaCl solution. Although this carbon steel is the most widely used material for reinforced concrete structures in Chile, there is limited research on its resistance to corrosion when in contact with saline solutions. The electrochemical reactions and their roles in the corrosion rate were studied using linear sweep voltammetry, weight loss, scanning electron microscopy, and X-ray diffraction techniques. This analysis is unique as it used the superposition model based on mixed potential theory to determine the electrochemical and corrosion parameters. The outcomes of this study show that A630-420H steel has a higher corrosion rate than those of the other commercial carbon steels studied. This fact can be attributed to the competition between the cathodic oxygen reduction reaction and hydrogen evolution reaction, which also depends on the environmental conditions, exposure time, stabilization of the corrosion products layer, and presence of chloride ions. Additionally, the results under mechanical stress conditions show a brittle fracture of the corrosion product oriented longitudinally in the direction of the bend section, where the presence of pores and cracks were also observed. The corrosion products after corrosion were mainly composed of magnetite and lepidocrocite oxide phases, which is in concordance with the electrochemical results. [ABSTRACT FROM AUTHOR]

Copyright of Hydrogeology & Engineering Geology / Shuiwendizhi Gongchengdizhi is the property of Hydrogeology & Engineering Geology Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Although saline is commonly used during cardiopulmonary resuscitation (CPR) or post-cardiac arrest care, it has detrimental effects. This trial aimed to evaluate the efficacy of a balanced crystalloid solution (Plasma Solution-A [PS]) in out-of-hospital cardiac arrest (OHCA) patients and compare it with the efficacy of saline. Methods: A randomized, unblinded clinical trial was conducted using PS and saline for intravenous fluid administration during CPR and post-cardiac arrest care of non-traumatic OHCA patients admitted to the emergency department of a tertiary university hospital. Patients received saline (saline group) or PS (PS group) within 24 h of hospital arrival. The primary outcomes were changes in arterial pH, bicarbonate, base excess (BE), and chloride levels within 24 h. The secondary outcomes were clinical outcomes including mortality. Results: Of the 364 patients, data from 27 and 26 patients in the saline and PS groups, respectively, were analyzed. Analysis using a linear mixed model revealed a significant difference in BE change over time between the groups (treatment-by-time p = 0.044). Increase in BE and bicarbonate levels from 30 min to 2 h was significantly greater (p = 0.044 and p = 0.024, respectively) and the incidence of hyperchloremia was lower (p < 0.001) in the PS group than in the saline group. However, there was no difference in clinical outcomes. Conclusion: Use of PS for resuscitation resulted in a faster improvement in BE and bicarbonate, especially in the early phase of post-cardiac arrest care, and lower hyperchloremia incidence than the use of saline, without differences in clinical outcomes, in OHCA patients. [ABSTRACT FROM AUTHOR]

Exercise-induced hypoalgesia (EIH) is characterized by an increase in pain threshold following acute exercise. EIH is reduced in some individuals with chronic musculoskeletal pain, although the mechanisms are unknown. It has been hypothesized that this may relate to whether exercises are performed in painful or non-painful body regions. The primary aim of this randomized experimental crossover study was to investigate whether the presence of pain per se in the exercising muscles reduced the local EIH response. The secondary aim was to investigate if EIH responses were also reduced in non-exercising remote muscles. Pain-free women (n=34) participated in three separate sessions. In session 1, the maximal voluntary contraction (MVC) for a single legged isometric knee extension exercise was determined. In sessions 2 and 3, pressure pain thresholds (PPT) were assessed at the thigh and shoulder muscles before and after a 3-min exercise at 30 % of MVC. Exercises were performed with or without thigh muscle pain, which was induced by either a painful injection (hypertonic saline, 5.8 %) or a non-painful injection (isotonic saline, 0.9 %) into the thigh muscle. Muscle pain intensity was assessed with an 11-point numerical rating scale (NRS) at baseline, after injections, during and after exercises. PPTs increased at thigh and shoulder muscles after exercise with painful (14.0–24.9 %) and non-painful (14.3–19.5 %) injections and no significant between-injection EIH differences were observed (p>0.30). Muscle pain intensity was significantly higher following the painful injection compared to the non-painful injection (p<0.001). Exercising painful muscles did not reduce the local or remote hypoalgesic responses, suggesting that the pain-relieving effects of isometric exercises are not reduced by exercising painful body regions. S-20210184. NCT05299268. [ABSTRACT FROM AUTHOR]

Hypertonic sodium chloride (HTS) is used for emergent treatment of acute cerebral edema and other neurologic emergencies. Central access is not commonly available in emergent situations and 3% HTS is utilized peripherally. Many studies have shown the safety of its administration at rates up to 75 mL/h, but there is a lack of data to establish the safety of peripherally administered, rapid bolus dosing in emergent situations. The objective of this study is to describe the safety of rapid, peripherally administered (≥ 250 mL/h) 3% HTS for neurologic emergencies. This is a retrospective, cohort study including adult patients receiving 3% HTS via a peripheral IV site for elevated intracranial pressure, cerebral edema, or other neurological emergencies at a rate of at least 250 m/h between May 5, 2018 – September 30, 2021. Patients were excluded if they simultaneously received another hypertonic saline fluid. Baseline characteristics collected included HTS dose, rate and site of administration, indication for use and patient demographics. The primary safety outcome was incidence of extravasation and phlebitis within one hour of HTS administration. There were 206 patients receiving 3% HTS who were screened, and 37 patients met inclusion criteria. The most common reason for exclusion was administration at a rate < 250 m/h. The median age was 60 (IQR 45, 72) with 51.4% being male. The most common indications for HTS were traumatic brain injury (45.9%) and intracranial hemorrhage (37.8%). The most common administration location was the emergency department (78.4%). The median IV-gauge (n = 29) was 18 (IQR 18, 20), with the most common placement site being antecubital (48.6%). The median dose of HTS was 250 mL (IQR 250, 350), with a median administration rate of 760 mL/h (IQR 500, 999). There were no episodes of extravasation or phlebitis noted. Rapid, peripheral administration of 3% HTS boluses is a safe alternative for treatment of neurologic emergencies. Administration at rates up to 999 mL/h did not result in extravasation or phlebitis. • HTS is used to treat several neurologic emergencies but use is commonly limited at to central line administration. • Peripheral, continuous 3% HTS up to rates of 75 ml/h is safe, but data lacks for rapid bolus administration peripherally. • We found no evidence of phlebitis or extravasation when 3% HTA was administered peripherally at rates above 250 ml/h. [ABSTRACT FROM AUTHOR]

Background: Previous research has shown diminished nasal immune function following nasal saline irrigation (NSI), returning to baseline at 6 hours. The aim of this study was to examine the immune nasal proteome before and after 14 days of nasal irrigation. Methods: Seventeen healthy volunteers received either isotonic (IsoSal) or low salt (LowNa) NSI. Nasal secretions were collected before and 30 min after NSI at baseline and again after 14 days. Specimens were analyzed using mass spectrometry to detect proteins of relevance to nasal immune function. Results: One thousand eight hundred and sixty-five proteins were identified with significant changes in 71 proteins, of which 23 were identified as part of the innate immune system. Baseline analysis demonstrated an increase of 9 innate proteins after NSI, most after IsoSal. After 14 days, a greater increase in innate peptides was present, with most now in the LowNa group. When NSI solutions were compared, a significant increase in 4 innate proteins, including a 211% in lysozyme, was detected in the LowNa group. Conclusion: LowNa NSI demonstrates evidence of improving the innate immune secretions, especially lysozyme, in healthy volunteers. [ABSTRACT FROM AUTHOR]

PurposeThe mechanisms of brain metastasis are incompletely understood. Circulating tumor cells travel to the right heart and through the pulmonary circulation, where they may become lung metastases, and can circulate further to the left heart and brain. In patients who develop brain metastases without lung involvement, we hypothesized that cancer cells may travel directly from the right atrium to left atrium via a patent foramen ovale (PFO), akin to paradoxical embolism. If the prevalence of PFO is greater in these individuals compared to the general population (20-30%), PFO may play a role in brain metastasis, and prophylactic closure may provide benefit. Accordingly, we investigated the prevalence of PFO in patients with brain metastases without prior lung involvement.MethodsWe prospectively identified patients with brain metastases from a non-lung primary cancer with no preceding or concurrent lung involvement. Nine eligible participants underwent a transcranial Doppler study with intravenous agitated saline to assess for PFO.ResultsAmong nine participants, primary cancers were breast (n = 6), upper gastrointestinal (n = 2), and thyroid (n = 1). A positive bubble study was identified in 2/9 (22.2%) participants: one female with breast cancer and one male with duodenal adenocarcinoma. No participants developed lung metastases on subsequent chest imaging.ConclusionIn this prospective pilot study, we found a similar prevalence of PFO in patients who developed brain metastases without preceding lung involvement compared to estimates for the general population. Through a larger study is needed, the development of brain metastases in these individuals may primarily reflect tumor-specific biological factors diecting metastasis organotropism.

Background/Aim. Septic shock (SS) is a complication that can occur as a consequence of an infection. As the effective circulating blood volume is of great importance in these cases, keeping constant track of the blood volume parameter is essential. The aim of this study was to explore the application value of bedside ultrasound for assessing volume responsiveness (VR) in patients with SS. Methods. A total of 102 patients with SS were selected. The volume load (VL) test was performed, and based on the results of the test, the patients were divided into two groups. The first group was the response (R) group, which had an increase in stroke volume (ΔSV) ≥ 15% after the VL test, and the second was the non-response (NR) group, with ΔSV < 15% after the VL test. There were 54 patients in the R group and 48 in the NR group. Hemodynamic parameters were compared before and after the VL test. The correlation between ΔSV and each hemodynamic index was explored by Pearson’s analysis. The receiver operating characteristic (ROC) curves were plotted for some of the parameters. Results. Before the VL test, retro-hepatic (RH) inferior vena cava (IVC) (RHIVC) distensibility (ΔRHIVC1) index, respiratory variation in RHIVC (ΔRHIVC2) index, respiratory variation in aortic (AO) blood flow peak velocity (ΔVpeakAO) index, respiratory variation in brachial artery (BA) blood flow peak velocity (ΔVpeakBA) index, and respiratory variation in common femoral artery (CFA) blood flow peak velocity (ΔVpeakCFA) index were all higher in the R group than those in the NR group (p < 0.05), while heart rate (HR), mean arterial pressure (MAP), and central venous pressure (CVP) were similar in both groups (p > 0.05). After the VL test, the R group had significantly decreased values of HR and the ΔRHIVC1, ΔRHIVC2, ΔVpeakAO, ΔVpeakBA, and ΔVpeakCFA indices, while the MAP and CVP values (p < 0.05) were increased. The NR group had a significantly decreased value of CVP (p < 0.05), while no significant changes were noticed in the values of other indices. The indices ΔRHIVC1, ΔRHIVC2, ΔVpeakAO, ΔVpeakBA, and ΔVpeakCFA significantly correlated with ΔSV (r = 0.589, r = 0.647, r = 0.697, r = 0.621, r = 0.766, respectively; p < 0.05), but there was no correlation between CVP and ΔSV (r = -0.345; p > 0.05). The areas under the curve (AUC) of ROC graphics for ΔRHIVC1, ΔRHIVC2, ΔVpeakAO, ΔVpeakBA, and ΔVpeakCFA indices, used for the prediction of VR, were 0.839, 0.858, 0.878, 0.916, and 0.921, respectively, and were significantly larger than the AUC of ROC graphic for CVP (0.691), indicating higher sensitivity and specificity of the ΔRHIVC1, ΔRHIVC2, ΔVpeakAO, ΔVpeakBA, and ΔVpeakCFA indices compared to CVP. Conclusion. Bedside ultrasound monitoring of the ΔRHIVC1, ΔRHIVC2, ΔVpeakAO, ΔVpeakBA, and ΔVpeakCFA indices can assess the VR in patients with SS more precisely.

Background: High-dose methotrexate (HDMTX) as a cytotoxic agent might cause various side effects. Hyperhydration has been implemented as the major strategy to decrease the potential risk of toxicities induced by HDMTX. This study aims to assess the renoprotective effect of hydration with dextrose water (DW) 5% versus normal saline (N/S) 0.9% against methotrexate (MTX) induced nephrotoxicity. Materials and Methods: This experimental animal study has been conducted on 36 Wistar rats (200–250 g) categorized into six groups, including male (n = 6) and female (n = 6) rats receiving sodium chloride 0.9% saline plus MTX, DW 5% plus MTX, or MTX alone. By the fifth day after the MTX injection, biochemical indexes were measured. The rats were also sacrificed and renal specimens were evaluated microscopically to determine kidney tissue damage (KTD). Results: The groups were not significantly different with regard to blood urea nitrogen (BUN) (P = 0.5), creatinine (Cr) (P = 0.24), kidney weight (P = 0.34), and urine flow (UF) (P = 0.5), while KTD score was remarkably less in the hydrated groups (P < 0.001). Weight loss in DW-treated rats was significantly more than N/S-treated ones, and creatinine clearance (CrCl) and urine load (UL) of Cr were statistically similar between males and females in the control group, but significantly lower among the DW5% treated males. Conclusion: Based on the findings of this study, hydration with N/S was superior to DW5% for the prevention from HDMTX-induced nephrotoxicity. Besides, we found insignificant differences between male versus female rats in response to the hydration for HDMTX-induced renoprotection; however, females probably benefit more.

Background/Aim. Septic shock (SS) is a complication that can occur as a consequence of an infection. As the effective circulating blood volume is of great importance in these cases, keeping constant track of the blood volume parameter is essential. The aim of this study was to explore the application value of bedside ultrasound for assessing volume responsiveness (VR) in patients with SS. Methods. A total of 102 patients with SS were selected. The volume load (VL) test was performed, and based on the results of the test, the patients were divided into two groups. The first group was the response (R) group, which had an increase in stroke volume (ΔSV) ≥ 15% after the VL test, and the second was the nonresponse (NR) group, with ΔSV < 15% after the VL test. There were 54 patients in the R group and 48 in the NR group. Hemodynamic parameters were compared before and after the VL test. The correlation between ΔSV and each hemodynamic index was explored by Pearson's analysis. The receiver operating characteristic (ROC) curves were plotted for some of the parameters. Results. Before the VL test, retrohepatic (RH) inferior vena cava (IVC) (RHIVC) distensibility (ΔRHIVC1) index, respiratory variation in RHIVC (ΔRHIVC2) index, respiratory variation in aortic (AO) blood flow peak velocity (ΔVpeakAO) index, respiratory variation in brachial artery (BA) blood flow peak velocity (ΔVpeakBA) index, and respiratory variation in common femoral artery (CFA) blood flow peak velocity (ΔVpeakCFA) index were all higher in the R group than those in the NR group (p < 0.05), while heart rate (HR), mean arterial pressure (MAP), and central venous pressure (CVP) were similar in both groups (p > 0.05). After the VL test, the R group had significantly decreased values of HR and the ΔRHIVC1, ΔRHIVC2, ΔVpeakAO, ΔVpeakBA, and ΔVpeakCFA indices, while the MAP and CVP values (p < 0.05) were increased. The NR group had a significantly decreased value of CVP (p < 0.05), while no significant changes were noticed in the values of other indices. The indices ΔRHIVC1, ΔRHIVC2, ΔVpeakAO, ΔVpeakBA, and ΔVpeakCFA significantly correlated with ΔSV (r = 0.589, r = 0.647, r = 0.697, r = 0.621, r = 0.766, respectively; p < 0.05), but there was no correlation between CVP and ΔSV (r = -0.345; p > 0.05). The areas under the curve (AUC) of ROC graphics for ΔRHIVC1, ΔRHIVC2, ΔVpeakAO, ΔVpeakBA, and ΔVpeakCFA indices, used for the prediction of VR, were 0.839, 0.858, 0.878, 0.916, and 0.921, respectively, and were significantly larger than the AUC of ROC graphic for CVP (0.691), indicating higher sensitivity and specificity of the ΔRHIVC1, ΔRHIVC2, ΔVpeakAO, ΔVpeakBA, and ΔVpeakCFA indices compared to CVP. Conclusion. Bedside ultrasound monitoring of the ΔRHIVC1, ΔRHIVC2, ΔVpeakAO, ΔVpeakBA, and ΔVpeakCFA indices can assess the VR in patients with SS more precisely. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the diagnostic performance of hip magnetic resonance (MR) arthrography with a gadolinium-based contrast agent (GBCA) or normal saline (NS) for intra-articular pathologies.Methods: This retrospective study was approved by the institutional review board of our hospital, and the requirement for informed consent was waived. The study included 37 consecutive patients (38 hips; 21 right hips; 24 males; mean age, 33 years) who underwent GBCA-hip MR arthrography from July 2011 to January 2020 and 30 consecutive patients (30 hips; 20 right hips; 21 males; mean age, 40 years) who underwent NS-hip MR arthrography from January 2018 to June 2020. All images were evaluated twice independently by two radiologists blinded to the arthroscopic findings for the presence of labral tears, cartilage abnormalities, or ligamentum teres tears. Intra- and inter-reader reliabilities were determined by kappa values (k) using the Chi-squared test, and diagnostic performance was evaluated based on the arthroscopic findings. A p-value less than 0.05 was considered to indicate statistical significance.Results: Intra-reader reliability in the detection of intra-articular pathologies ranged from moderate to almost perfect (k =0.510-0.840) and inter-reader reliability ranged from moderate to substantial (k =0.441-0.695) for GBCA- and NS-hip MR arthrography. The diagnostic accuracy of GBCA- and NS-hip MR arthrography was as follows: 81.6-92.1% and 66.7-73.3% for labral tears, respectively; 68.4-86.8% and 63.3-70.0% for cartilage abnormality, respectively; and 68.4-76.3% and 50.0-56.7% for ligamentum teres tears, respectively.Conclusion: NS-hip MR arthrography may be less accurate than GBCA-hip MR arthrography.Level Of Evidence: Level II of Development of diagnostic criteria (consecutive patients with consistently applied reference standard and blinding). [ABSTRACT FROM AUTHOR]

BackgroundAcute treatment of cerebral edema and elevated intracranial pressure is a common issue in patients with neurological injury. Practical recommendations regarding selection and monitoring of therapies for initial management of cerebral edema for optimal efficacy and safety are generally lacking. This guideline evaluates the role of hyperosmolar agents (mannitol, HTS), corticosteroids, and selected non-pharmacologic therapies in the acute treatment of cerebral edema. Clinicians must be able to select appropriate therapies for initial cerebral edema management based on available evidence while balancing efficacy and safety.MethodsThe Neurocritical Care Society recruited experts in neurocritical care, nursing, and pharmacy to create a panel in 2017. The group generated 16 clinical questions related to initial management of cerebral edema in various neurological insults using the PICO format. A research librarian executed a comprehensive literature search through July 2018. The panel screened the identified articles for inclusion related to each specific PICO question and abstracted necessary information for pertinent publications. The panel used GRADE methodology to categorize the quality of evidence as high, moderate, low, or very low based on their confidence that the findings of each publication approximate the true effect of the therapy.ResultsThe panel generated recommendations regarding initial management of cerebral edema in neurocritical care patients with subarachnoid hemorrhage, traumatic brain injury, acute ischemic stroke, intracerebral hemorrhage, bacterial meningitis, and hepatic encephalopathy.ConclusionThe available evidence suggests hyperosmolar therapy may be helpful in reducing ICP elevations or cerebral edema in patients with SAH, TBI, AIS, ICH, and HE, although neurological outcomes do not appear to be affected. Corticosteroids appear to be helpful in reducing cerebral edema in patients with bacterial meningitis, but not ICH. Differences in therapeutic response and safety may exist between HTS and mannitol. The use of these agents in these critical clinical situations merits close monitoring for adverse effects. There is a dire need for high-quality research to better inform clinicians of the best options for individualized care of patients with cerebral edema.

Heterochronic blood sharing rejuvenates old tissues, and most of the studies on how this works focus on young plasma, its fractions, and a few youthful systemic candidates. However, it was not formally established that young blood is necessary for this multi-tissue rejuvenation. Here, using our recently developed small animal blood exchange process, we replaced half of the plasma in mice with saline containing 5% albumin (terming it a "neutral" age blood exchange, NBE) thus diluting the plasma factors and replenishing the albumin that would be diminished if only saline was used. Our data demonstrate that a single NBE suffices to meet or exceed the rejuvenative effects of enhancing muscle repair, reducing liver adiposity and fibrosis, and increasing hippocampal neurogenesis in old mice, all the key outcomes seen after blood heterochronicity. Comparative proteomic analysis on serum from NBE, and from a similar human clinical procedure of therapeutic plasma exchange (TPE), revealed a molecular re-setting of the systemic signaling milieu, interestingly, elevating the levels of some proteins, which broadly coordinate tissue maintenance and repair and promote immune responses. Moreover, a single TPE yielded functional blood rejuvenation, abrogating the typical old serum inhibition of progenitor cell proliferation. Ectopically added albumin does not seem to be the sole determinant of such rejuvenation, and levels of albumin do not decrease with age nor are increased by NBE/TPE. A model of action (supported by a large body of published data) is that significant dilution of autoregulatory proteins that crosstalk to multiple signaling pathways (with their own feedback loops) would, through changes in gene expression, have long-lasting molecular and functional effects that are consistent with our observations. This work improves our understanding of the systemic paradigms of multi-tissue rejuvenation and suggest a novel and immediate use of the FDA approved TPE for improving the health and resilience of older people.

BackgroundResuscitation with crystalloid fluid is a cornerstone of pediatric septic shock treatment. However, the optimal type of crystalloid fluid is unknown. We aimed to determine the feasibility of conducting a pragmatic randomized trial to compare balanced (lactated Ringer's [LR]) with 0.9% normal saline (NS) fluid resuscitation in children with suspected septic shock.MethodsOpen-label pragmatic randomized controlled trial at a single academic children's hospital from January to August 2018. Eligible patients were >6 months to

Abstract Background Traumatic brain injury (TBI) causes mortality and long-term disability among young adults and imposes a notable cost on the healthcare system. In addition to the first physical hit, secondary injury, which is associated with increased intracranial pressure (ICP), is defined as biochemical, cellular, and physiological changes after the physical injury. Mannitol and Hypertonic saline (HTS) are the treatment bases for elevated ICP in TBI. This systematic review and meta-analysis evaluates the effectiveness of HTS in the management of patients with TBI. Methods This study was conducted following the Joanna Briggs Institute (JBI) methods and PRISMA statement. A systematic search was performed through six databases in February 2022, to find studies that evaluated the effects of HTS, on increased ICP. Meta-analysis was performed using comprehensive meta-analysis (CMA). Results Out of 1321 results, 8 studies were included in the systematic review, and 3 of them were included in the quantitative synthesis. The results of the meta-analysis reached a 35.9% (95% CI 15.0–56.9) reduction in ICP in TBI patients receiving HTS, with no significant risk of publication bias (t-value = 0.38, df = 2, p-value = 0.73). The most common source of bias in our included studies was the transparency of blinding methods for both patients and outcome assessors. Conclusion HTS can significantly reduce the ICP, which may prevent secondary injury. Also, based on the available evidence, HTS has relatively similar efficacy to Mannitol, which is considered the gold standard therapy for TBI, in boosting patients' neurological condition and reducing mortality rates.

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A correlation for dynamic viscosity of aqueous lithium bromide solution is proposed. The correlation is based on an empirical approach accounting for physical limitations. The data are compiled from 11 sources over a temperature range from − 20 ∘ C to 110 ∘ C and from pure water to salt mass fractions of 65 %. The correlation succeeds in predicting the solution's viscosity over the chosen range of measured data. In most parts of its validity range the accuracy is significantly improved compared to previous equations. [ABSTRACT FROM AUTHOR]

Little information is available about how intravenous bolus injection of iopromide 370 twice in a short time will affect hemodynamics and whether the changes reach clinically relevant levels. In the present study, 31 healthy adult volunteers received abdominal contrast-enhanced CT and coronary CTA sequential examinations. The same dose and rate of normal saline was injected 30 min in advance as self-control. Hemodynamic data were noninvasively collected at selected time points from 1 min prior to injection to 30 min post-injection. The results showed that after iopromide 370 injection, except for stroke volume, all other indicators changed immediately during the first injection, changed most significantly during the second injection (P < 0.05), and returned to baseline within 10 min. Heart rate and cardiac output exhibited the most pronounced changes, with an increasing rate of 33.5% and 33.8%, respectively. For indicators with a change range of > 15% during the second injection, except for mean arterial pressure and total peripheral resistance, the proportions of subjects for the other indicators between the two groups were statistically different (P < 0.05). In conclusion, intravenous bolus injection of iopromide 370 twice in dual-site sequential examinations induced dose-cumulative and time-dependent hemodynamic effects, which all fluctuated within the normal ranges. [ABSTRACT FROM AUTHOR]

Background: Human exposure to fungal elements is inevitable. Normal inhalation routinely deposits fungal spores within the nose and paranasal sinuses. Incidence of fungal infections are increasing, because of the greater use of immunosuppressive, increasing incidence of transplantation, chemotherapy, HIV infection, and diabetes mellitus. The aim of this research was to study the effects of nasal irrigation with normal saline on eliminating nasal fungal flora. Methods: We studied the clinical efficacy of nasal saline irrigation on the healthy individuals in a pilot study. Nasal swabs were used to get the nasal samples from 140 cases, 90 women and 50 men, currently living in Tehran. Those cases with positive fungal cultures, underwent nasal saline irrigation. They were reevaluated with nasal sampling and culture after a week. Results: Positive fungal culture was detected in 22 cases (15.7%): saprophyte fungi were the most common (45.4%). After nasal saline irrigation, negative fungal cultures were found in 54.5% of cases (P value=0.0009). Conclusions: This study demonstrated that nasal irrigation with nasal saline appears to be both safe and effective on the eradication of nasal fungal flora. So, it seems to be useful in prevention and management of all types of fungal rhinosinusitis.

ObjectiveTo determine the effect of 5% sodium chloride ophthalmic ointment (5% NaCl) on thickness and morphology of the normal canine cornea using ultrasonic pachymetry (USP), in vivo confocal microscopy (IVCM), and Fourier-domain optical coherence tomography (FD-OCT).MethodsFive healthy laboratory Beagles received ophthalmic examinations including USP, IVCM, and FD-OCT prior to and at fixed intervals following treatment. The right and left eyes were treated with 5% NaCl and artificial tears ophthalmic ointment (AT), respectively, every 2 hours for 4 treatments/d (days 2-9), and then hourly for 7 treatments/d (day 10). Treatment groups were statistically compared using mixed-effects linear regression.ResultsTreatment with 5% NaCl resulted in a 12 μm decrease in corneal thickness from baseline (P  .05).ConclusionsShort-term topical treatment with 5% NaCl decreased corneal thickness in normal dogs with no observable changes in corneal morphology or signs of ocular toxicity.