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Abstract Background We aimed to determine the time interval between alfentanil and rocuronium administration, at a 50% probability of preventing pain-induced withdrawal movement from rocuronium injection (TimeAR50). Methods A total of 64 patients scheduled for general anesthesia were enrolled in this study (33 men and 31 women). Anesthesia was induced with target-controlled infusion of propofol, at an effect-site target concentration of 3 μg/mL. Then, alfentanil 15 μg/kg was injected for 30 s. After 60 s, rocuronium 0.6 mg/kg was administered to the first patient. The Dixon’s up-and-down method was used to determine the time interval for each subsequent patient (interval of 5 s). Mean arterial pressure (MAP) and heart rate (HR) were recorded at three time points: T0, pre-induction; T1, before rocuronium injection; and T2, 1 min after rocuronium injection. Results The TimeAR50 ± standard deviation (SD) was 5.6 ± 3.7 s and 21.9 ± 5.6 s in the male and female patients, respectively. Based on the probit regression, the TimeAR50 was 4.7 s (95% confidence interval [CI], 1.2–7.6 s) and 20.3 s (95% CI, 7.7–26.1 s) in the male and female patients, respectively. The TimeAR95 was 10.6 s (95% CI, 7.7–25.3 s) and 35.0 s (95% CI, 28.1–95.5 s) in the male and female patients, respectively, with significantly higher values in females than in males (P

Lead-free alkali halides have gained increasing attention owing to their desired optoelectronic properties across a variety of light-emitting applications. However, state-of-the-art alkali halide emitters commonly are bulky crystals functionalized with highly toxic elemental doping, hindering their integration into emerging flexible, wearable and large-area optoelectronic devices. Herein, we have developed environmental friendly and solution-processable alkali halide nanocrystals that exhibit intense self-trapped emission facilitated by Sn2+ ionic doping. We find that the presence of Sn2+-interstitial leads to the tilting of cubic structures of RbI and thus triggers the self-trapped emission. The resultant tin(II)-doped RbI and RbxCs1−xI nanocrystals display an impressive maximum photoluminescence quantum yield of 91.9% and exhibit remarkable stability under ambient conditions. These findings pave the way for a new class of bright, solution-processable alkali halides, with diverse applications such as energy down conversion and flexible scintillation technologies. [ABSTRACT FROM AUTHOR]

BackgroundEosinophilic leukemia (EL) is a rare, serious and potentially life-threatening condition characterized by the overproduction of eosinophils leading to tissue eosinophilic infiltration and damage. Although multiple organ systems may be involved, progressive eosinophilic myocarditis (EM) is the most common cause of morbidity and mortality. Early diagnosis and follow-up surveillance combined with multimodal imaging are crucial for appropriate treatment of EM.Case SummaryIt’s a rare case of EL with EM and intracardiac thrombus in a 59-year-old patient who presented with asthenia for 3 weeks. Full blood count analysis indicated significant eosinophilia. Bone marrow aspirate revealed dysplastic eosinophilia and a FIP1L1-PDGFRA fusion gene (4q12) was detected, confirming EL. Echocardiography revealed EM with intracardiac thrombus. This was later confirmed by cardiac magnetic resonance imaging. The patient was commenced on imatinib and prednisolone and good clinical response was obtained. Through 18F-FAPI PET/CT imaging, we obtained in vivo visualization of fibroblast activation changes in the early stage of cardiac structure remodeling. With anti-fibrotic therapy after heart failure, the patient achieved a good clinical response.ConclusionThis case demonstrates in vivo visualization of fibroblast activation after EM. Multimodality imaging can provide early diagnosis and may guide tailored antifibrotic therapy in early stage of EM.

Abstract Background The SCN11A gene, encoded Nav1.9 TTX resistant sodium channels, is a main effector in peripheral inflammation related pain in nociceptive neurons. The role of SCN11A gene in the auditory system has not been well characterized. We therefore examined the expression of SCN11A in the murine cochlea, the morphological and physiological features of Nav1.9 knockout (KO) ICR mice. Results Nav1.9 expression was found in the primary afferent endings beneath the inner hair cells (IHCs). The relative quantitative expression of Nav1.9 mRNA in modiolus of wild-type (WT) mice remains unchanged from P0 to P60. The number of presynaptic CtBP2 puncta in Nav1.9 KO mice was significantly lower than WT. In addition, the number of SGNs in Nav1.9 KO mice was also less than WT in the basal turn, but not in the apical and middle turns. There was no lesion in the somas and stereocilia of hair cells in Nav1.9 KO mice. Furthermore, Nav1.9 KO mice showed higher and progressive elevated ABR threshold at 16 kHz, and a significant increase in CAP thresholds. Conclusions These data suggest a role of Nav1.9 in regulating the function of ribbon synapses and the auditory nerves. The impairment induced by Nav1.9 gene deletion mimics the characters of cochlear synaptopathy.

Microalloyed steels have emerged to replace conventional plain-carbon steels to achieve longer wheel life on Chinese railroads. In this work, with the aim of preventing spalling, a mechanism that consists of ratcheting and shakedown theory correlated with steel properties is systematically investigated. Mechanical and ratcheting tests were carried out for microalloyed wheel steel to which vanadium was added in the range of 0–0.15 wt.% and the results were compared with that obtained for conventional plain-carbon wheel steel. The microstructure and precipitation were characterized via microscopy. As a result, the grain size was not obviously refined, and the pearlite lamellar spacing decreased from 148 nm to 131 nm in microalloyed wheel steel. Moreover, an increase in the number of vanadium carbide precipitates was observed, which were mainly dispersed and uneven, and precipitated in the pro-eutectoid ferrite region, in contrast to the observation of lower precipitation in the pearlite. It has been found that vanadium addition can lead to an increase in yield strength by precipitation strengthening, with no reduction or increase in tensile strength, elongation or hardness. The ratcheting strain rate for microalloyed wheel steel was determined to be lower than that for plain-carbon wheel steel via asymmetrical cyclic stressing tests. An increase in the pro-eutectoid ferrite content leads to beneficial wear, which can diminish spalling and surface-initiated RCF.

This article considers a new improved balanced joint progressive type-II censoring scheme based on two different populations, where the lifetime distributions of two populations follow the generalized inverted exponential distribution with different shape parameters but a common scale parameter. The maximum likelihood estimates of all unknown parameters are obtained and their asymptotic confidence intervals are constructed by the observed Fisher information matrix. Furthermore, the existence and uniqueness of solutions are proved. In the Bayesian framework, the common scale parameter follows an independent Gamma prior and the different shape parameters jointly follow a Beta-Gamma prior. Based on whether the order restriction is imposed on the shape parameters, the Bayesian estimates of all parameters concerning the squared error loss function along with the associated highest posterior density credible intervals are derived by using the importance sampling technique. Then, we use Monte Carlo simulations to study the performance of the various estimators and a real dataset is discussed to illustrate all of the estimation techniques. Finally, we seek an optimum censoring scheme through different optimality criteria.

Biofilms are communities formed by bacteria adhering to surfaces, widely present in porous medium, and their growth can lead to clogging. Our experiment finds that under certain flow conditions, biofilms detach in pores and form a dynamically changing flow path. We define detachment that occurs far from the boundary of the flow path (with a distance greater than 200 μm) as internal detachment and detachment that occurs at the boundary of the flow path as external detachment. To understand the mechanism of biofilm detachment, we study the detachment behaviors of the Bacillus subtilis biofilm in a porous medium in a microfluidic device, where Bacillus subtilis strain is triple fluorescent labeled, which can represent three main phenotypes during the biofilm formation: motile cells, matrix-producing cells, and spores. We find that slow small-scale internal detachment occurs in regions with very few motile cells and matrix-producing cells, and bacterial movement in these areas is disordered. The increase in the number of matrix-producing cells induces clogging, and after clogging, the rapid detachment of the bulk internal biofilm occurs due to the increased pressure difference at the inlet and outlet. When both internal and external detachments occur simultaneously, the number of matrix-producing cells in the internal detachment area is 2.5 times that in the external detachment area. The results indicate that biofilm detachment occurs in areas with fewer matrix-producing cells, as matrix-producing cells can help resist detachment by secreting extracellular polymeric substances (EPSs). [ABSTRACT FROM AUTHOR]

In the livestock industry, an excessive accumulation of subcutaneous fat diminishes the proportion of lean meat, while elevated intramuscular fat (IMF) content is associated with enhanced meat quality. However, the heterogeneity of various fat depots in pigs remains incompletely understood. Comprehensive tissue section, lipidomic, and transcriptomic analyses indicated that the maturity of IMF was significantly less than that of both intermuscular and subcutaneous fats. We identified 467 lipids across 29 lipid classes in total, revealing that IMF exhibits unique lipid composition and transcriptional profiles. More importantly, several lipids, including GalCer, S1P, CL, AcCa, PC-O, PE-O, and sulfatide, are highly enriched in intramuscular fat and may play pivotal roles in neuromodulation, mitochondrial function, lipogenesis, and membrane signaling. In conclusion, we unveiled unique lipid composition and molecular regulatory pathways of porcine IMF, offering new insights for the synergistic breeding that aims at optimizing pig backfat thickness and IMF content. [ABSTRACT FROM AUTHOR]

Background: The predictive power of the CHADS2 and CHA2DS2-VASc scores for the presence of Left atrial thrombus (LAT)/ spontaneous echo contrast (SEC) in non-valvular atrial fibrillation (NVAF) is modest. The aim of this analysis is to define clinical and ultrasonic variables associated with LAT/SEC and to propose nomograms for individual risk prediction.Methods: Data on 1,813 consecutive NVAF patients who underwent transesophageal echocardiography (TEE) from January 2016 to January 2021 were collected. The univariate and multivariate logistic regression analyses were used to construct a nomogram. We examined the predictive ability of the risk scores by calculating the area under the curve (AUC). Moreover, the performance of the nomogram was assessed with respect to calibration, discrimination, and clinical usefulness.Results: LAT/SEC was found in 260 (21.0%) and 124 (21.6%) patients in the training and validation cohorts, respectively. On multivariate analysis, independent factors for LAT/SEC were Age, left atrial diameter (LAD), left ventricular ejection fraction (LVEF), hypertension (HTN), previous stroke or transient ischemic attack, Non-paroxysmal AF and a nomogram was built based on these variables. The calibration curve for the probability of LAT/SEC showed good prediction agreement with actual observation. The nomogram achieved good concordance indexes of 0.836 and 0.794 in predicting LAT/SEC in the training and validation cohorts, respectively. Decision curve analysis demonstrated that the nomogram would be clinically useful.Conclusions: In this study, a nomogram was constructed that incorporated six characteristics of NVAF patients. The nomogram may be of great value for the prediction of LAT/SEC in NVAF patients.

Abstract. Background:. Pulmonary vein (PV) occlusion generally depends on repetitive contrast agent injection when cryoballoon ablation for atrial fibrillation (AF). The present study was to compare the effect of cryoballoon ablation for AF guided by transesophageal echocardiography (TEE) vs. contrast agent injection. Methods:. Eighty patients with paroxysmal AF (PAF) were enrolled in the study. About 40 patients underwent cryoballoon ablation without TEE (non-TEE group) and the other 40 underwent cryoballoon ablation with TEE for PV occlusion (TEE group). In the TEE group during the procedure, PVs were displayed in 3-dimensional images to guide the balloon to achieve PV occlusion. The patients were followed up at regularly scheduled visits every 2 months. Results:. No differences were identified between the groups in regard to the procedure time and cryoablation time for each PV. The fluoroscopy time (6.7 ± 4.2 min vs. 17.9 ± 5.9 min, P

Abstract Background Atrial fibrillation (AF) can result in atrial functional mitral regurgitation (MR), but the mechanism remains controversial. Few data about the relationship between the 3-dimensional morphology of the MV and the degree of MR in AF exist. Methods Real-time 3-dimensional transesophageal echocardiography (3D-TEE) of the MV was acquired in 168 patients with AF (57.7% persistent AF), including 25 (14.9%) patients with moderate to severe MR (the MR+ group) and 25 patients without AF as controls. The 3-dimensional geometry of the MV apparatus was acquired using dedicated quantification software. Results Compared with the group of patients with no or mild MR (the MR- group) and the controls, the MR+ group had a larger left atrium (LA), a more dilated mitral annulus (MA), a reduced annular height to commissural width ratio (AHCWR), indicating flattening of the annular saddle shape, and greater leaflet surfaces and tethering. MR severity was correlated with the MA area (r2 = 0.43, P