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INTRODUCTION: Donation after circulatory death (DCD) donors are becoming an important source of organs for heart-transplantation (HT), but there are limited data regarding their use in multiorgan-HT. METHODS: Between January 2020 and June 2023, we identified 87 adult multiorgan-HTs performed using DCD-donors [77 heart-kidney, 6 heart-lung, 4 heart-liver] and 1494 multiorgan-HTs using donation after brain death (DBD) donors (1141 heart-kidney, 165 heart-lung, 188 heart-liver) in UNOS. For heart-kidney transplantations (the most common multiorgan-HT combination from DCD-donors), we also compared donor/recipient characteristics, and early outcomes, including 6-month mortality using Kaplan-Meier (KM) and Cox hazards-ratio (Cox-HR). RESULTS: Use of DCD-donors for multiorgan-HTs in the United States increased from 1% in January to June 2020 to 12% in January-June 2023 (p < 0.001); but there was a wide variation across UNOS regions and center volumes. Compared to recipients of DBD heart-kidney transplantations, recipients of DCD heart-kidney transplantations were less likely to be of UNOS Status 1/2 at transplant (35.06% vs. 69.59%) and had lower inotrope use (22.08% vs. 43.30%), lower IABP use (2.60% vs. 26.29%), but higher durable CF-LVAD use (19.48% vs. 12.97%), all p < 0.01. Compared to DBD-donors, DCD-donors used for heart-kidney transplantations were younger [28(22-34) vs. 32(25-39) years, p = 0.004]. Recipients of heart-kidney transplantations from DCD-donors and DBD-donors had similar 6-month survival using both KM analysis, and unadjusted and adjusted Cox-HR models, including in propensity matched cohorts. Rates of PGF and in-hospital outcomes were also similar. CONCLUSIONS: Use of DCD-donors for multiorgan-HTs has increased rapidly in the United States and early outcomes of DCD heart-kidney transplantations are promising.
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Sobrevivência de Enxerto , Transplante de Coração , Doadores de Tecidos , Obtenção de Tecidos e Órgãos , Humanos , Feminino , Masculino , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Transplante de Coração/mortalidade , Pessoa de Meia-Idade , Doadores de Tecidos/provisão & distribuição , Estados Unidos , Seguimentos , Adulto , Prognóstico , Taxa de Sobrevida , Estudos Retrospectivos , Morte EncefálicaRESUMO
This study aimed to investigate the impact of polysaccharide type on the physicochemical, structural, and thermal properties of dielectric barrier discharge (DBD) plasma glycosylated sodium caseinate (SC). The polysaccharides Quince seed gum (QSG), carboxymethyl cellulose (CMC), and maltodextrin (MD) were mixed with SC and treated with DBD plasma at 18â¯kV for 10â¯min. The grafting degree, electrophoresis pattern, FTIR, XRD, carbonyl, sulfhydryl, and di-tyrosine content, FE-SEM, color, and thermal properties of SC and its polysaccharide mixtures before and after plasma treatment were analyzed. Results showed that the SC-QSG conjugate had the highest glycation degree and color change after plasma treatment. The SC-CMC and SC-QSG conjugates exhibited disappearance of distinct SC bands in electrophoresis pattern compared to SC. Also, significant changes in functional group and crystallinity were occurred in SC-CMC conjugate. Plasma treatment caused oxidation of SC, but the presence of polysaccharides offered protection against oxidation. The microstructure of SC was altered by mixing with polysaccharides and exposure to plasma. Also, the mixtures indicates higher thermal stability after plasma treatment. Results confirmed that the generation of protein-polysaccharide conjugates through DBD plasma technique was depended on with SC-MD conjugate unable to form through this method.
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Molecularly imprinted polymers (MIPs) are synthetic polymers that mimic the functions of antibodies. Though MIPs are promising tools in various areas, achieving high selectivity in MIPs can be difficult. To improve selectivity, various approaches have been implemented; however, the role of polymerization methods or synthetic techniques in enhancing the selectivity of MIPs has not been studied and remains a crucial area for further research. MIPs are typically prepared from free radical reactions. Recently, we found that Dielectric Barrier Discharge (DBD) plasma can be used to initiate the polymerization of vinyl monomers. The DBD plasma method allows the monomers to associate with the template molecules and initiate polymerization with minimal disruption to the positioning of the monomers. We hypothesize that this could be a preferred method to prepare MIPs over the traditional radical reaction that may cause a disturbance of the pre-associated monomers on the templates for the polymerization. Chicken egg white serum albumin (CESA) was used as the template protein for the MIPs. Our results show that in all test conditions, approximately twofold improvement in selectivity was achieved, which is the primary performance metric for MIPs. This enhancement was evident across all categories, including MIPs prepared from various monomer combinations.
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This study aims to fine-tune the plasma composition with a particular emphasis on reactive nitrogen species (RNS) including nitrogen dioxide (NO2), dinitrogen pentoxide (N2O5), and nitrous oxide (N2O), produced by a self-constructed cylindrical dielectric barrier discharge (CDBD). We demonstrated the effective manipulation of the plasma chemical profile by optimizing electrical properties, including the applied voltage and frequency, and by adjusting the nitrogen and oxygen ratios in the gas mixture. Additionally, quantification of these active species was achieved using Fourier transform infrared spectroscopy. The study further extends to exploring the aerosol polymerization of acrylamide (AM) into polyacrylamide (PAM), serving as a model reaction to evaluate the reactivity of different plasma-generated species, highlighting the significant role of NO2 in achieving high polymerization yields. Complementing our experimental data, molecular dynamics (MD) simulations, based on the ReaxFF reactive force field potential, explored the interactions between reactive oxygen species, specifically hydroxyl radicals (OH) and hydrogen peroxide (H2O2), with water molecules. Understanding these interactions, combined with the optimization of plasma chemistry, is crucial for enhancing the effectiveness of DBD plasma in environmental applications like air purification and water treatment.
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Elemental mercury (Hg0) removal is a crucial target for mercury pollution control in flue gas. This article focuses on Hg0 removal in flue gas using corona discharge (CD) and dielectric barrier discharge (DBD) technologies, and provides a mechanistic perspective on the development and influencing factors of non-thermal plasma (NTP) technology for Hg0 removal. The influence factors include reactor configurations, power supplies, energy density, residence time, oxidation methods, gas composition, and the synergy between NTP and catalysis/adsorption, etc. This study reveals that the use of a pulsating electrical power supply significantly increases electron densities in both CD and DBD systems, thereby ensuring high energy efficiency and economic viability. Cl2 proves to be more effective than HCl as a chlorine source for Hg0 removal. NO significantly reduces Hg0 oxidation efficiency, while the effects of SO2 and H2O remain unclear. Energy density distribution is closely related to plasma devices, power supplies, and overall reactor configurations. Direct oxidation proves to be more effective than indirect oxidation for Hg0 removal. The combination of NTP with adsorption/catalysis technologies shows significantly better Hg0 removal efficiency compared to using NTP alone. This study can provide theoretical support for enhancing Hg0 removal mechanisms and optimizing process control parameters in industrial applications of NTP technology.
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Dual base editors (DBEs) enable simultaneous A-to-G and C-to-T conversions, expanding mutation types. However, low editing efficiency and narrow targeting range limit the widespread use of DBEs in plants. The single-strand DNA binding domain of RAD51 DBD can be fused to base editors to improve their editing efficiency. However, it remains unclear how the DBD affects dual base editing performance in plants. In this study, we generated a series of novel plant DBE-SpGn tools consisting of nine constructs using the high-activity cytidine deaminase evoFERNY, adenosine deaminase TadA8e and DBD in various fusion modes with the PAM-flexible Streptococcus pyogenes Cas9 (SpCas9) nickase variant SpGn (with NG-PAM). By analysing their editing performance on 48 targets in rice, we found that DBE-SpGn constructs containing a single DBD and deaminases located at the N-terminus of SpGn exhibited the highest editing efficiencies. Meanwhile, constructs with deaminases located at the C-terminus and/or multiple DBDs failed to function normally and exhibited inhibited editing activity. We identified three particularly high-efficiency dual base editors (C-A-SpGn, C-A-D-SpGn and A-C-D-SpGn), named PhieDBEs (Plant high-efficiency dual base editors), capable of producing efficient dual base conversions within a narrow editing window (M5 ~ M9, M = A/C). The editing efficiency of C-A-D-SpGn was as high as 95.2% at certain target sites, with frequencies of simultaneous C-to-T and A-to-G conversions as high as 81.0%. In summary, PhieDBEs (especially C-A-D-SpGn) can produce diverse mutants and may prove useful in a wide variety of applications, including plant functional genomics, precise mutagenesis, directed evolution and crop genetic improvement, among others.
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Non-thermal dielectric barrier discharge (DBD) plasma has received great attention for degradation of persistent organic pollutants such as p-nitrophenol (PNP). However, the feasibility of the DBD implementation is not clear due to its high energy consumption and relatively low degradation efficiency. In this research, a novel strategy was suggested based on re-circulation of the generated O3 in the DBD system to enhance the PNP degradation efficiency and energy yield. The potential mechanism and possible pathway of PNP degradation were studied by EPR, ESR, DFT and GS-MS analytical tests. According to the results, the PNP degradation efficiency and energy yield increased from 57.4% to 94.4% and from 0.52 to 1.18 g kW-1h-1, respectively through ozone circulation into the DBD reactor. This was due to the more release of long-lived and short-lived reactive species (ROS) in the DBD-O3 system by the O3 circulation. The variations in pH (4-10), initial concentration (50-90 mg L-1), and the presence of co-existing substances in the water matrix had minimal impact on the DBD-O3 system, in comparison to the conventional system. The biological toxicity evaluation revealed that the hybrid DBD-O3 system transform PNP to less toxic intermediates. This study proposes a promising strategy to improve the utilization of DBD for the degradation of PNP.
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Nitrofenóis , Ozônio , Poluentes Químicos da Água , Nitrofenóis/química , Ozônio/química , Poluentes Químicos da Água/química , Cinética , Gases em Plasma/química , Purificação da Água/métodos , Água/químicaRESUMO
Lahore (Pakistan), being an industrial city, has high emission of aerosols that affects and contaminates the air quality. Therefore, the abatement/inactivation of aerosols is necessary to restrict their infectious activities. In this project, ionic wind isolated from dielectric barrier discharge plasma (DBD plasma) has been utilized to abate the aerosols trapped in the Surgical Mask and KN95 Respirator. To infer the chemical and elemental detection of ambient aerosols, FTIR and LIBS have been employed. "From the results, it is noteworthy that abatement/removal of aerosols has been successfully carried out by the ionic wind irradiation and highlights the potential of DBD plasma technology in removing the aerosols pollution."
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Sampling and chromatography-mass spectrometry methods were investigated to measure atmospheric amines and aminoamides. Amines and their amide derivatives play significant roles in new particle formation (NPF) in the atmosphere, especially diamines and aminoamides have higher NPF potentials compared to monoamines. For amine sampling, silica gel tube collection and formic acid extraction gave good overall recoveries (>93 ± 8%) for mono-, di-, tri-, tetramines, and aminoamides. Two chromatography methods were subjected to analyze the extracted amines. One involved direct analysis using hydrophilic interaction liquid chromatography with carboxyl or diol group functioned separation column (carboxyl-HILIC or diol-HILIC), and the other utilized derivatization with 4-(N,N-dimethylaminosulfonyl)-7-fluoro-2,1,3-benzoxadiazole (DBD-F) and subsequent reversed-phase chromatography (HPLC). Separated amines were detected by electrospray ionization and tandem mass spectrometry in both cases. DBD-F-HPLC method provided good sensitivity for mono- and all polyamines (limit of detection (LOD) < 4.6 nM, relative standard deviation (RSD) for 100 nM < 9.2%). However, aminoamides could not be detected by DBD-F-HPLC. Carboxyl-HILIC provided good sensitivities for mono- and diamines and aminoamides (LOD < 1.6 nM, RSD < 4.8%). Forest air measurement was performed and data obtained by carboxyl-HILIC and DBD-F-HPLC showed good agreement for 1,3-diaminopropane, 1,4-diaminobutane (putrescine) and 1,5-diaminopentane (cadaverine) (R2 = 0.9215-0.9739, n = 7-14). Carboxyl-HILIC method was the best for the amine analysis, and combination with silica gel tube sampling provides atmospheric monitoring available. The developed method can be used not only to study atmospheric chemistry of diamines and aminoamides but also to analyze flavor/odor of foods, flowers and wastes.
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Organ procurement organizations (OPOs) face increasing regulatory scrutiny, and the performance of predictive models used to assess OPO performance is critical. We sought to determine whether adding deceased donor physiological and critical care data to the existing Scientific Registry of Transplant Recipients (SRTR) heart yield model would improve the model's performance. Donor data and heart transplanted (yes/no), the outcome of interest, were obtained from the United Network for Organ Sharing Donor Management Goal (DMG) Registry for 19 141 donors after brain death, from 25 OPOs. The data were split into training and testing portions. Multivariable LASSO regression was used to develop a statistical model incorporating DMG data elements with the existing components of the SRTR model. The DMG + SRTR and SRTR models were applied to the test data to compare the predictive performance of the models. The sensitivity (84%-86%) and specificity (84%-86%) were higher for the DMG + SRTR model compared to the SRTR model (71%-75% and 76%-77%, respectively). For the DMG + SRTR model, the C-statistic was 0.92 to 0.93 compared to 0.80 to 0.81 for the SRTR model. DMG data elements improve the predictive performance of the heart yield model. The addition of DMG data elements to the Organ Procurement and Transplantation Network data collection requirements should be considered.
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This study investigated the synergistic effect of combining flavourzyme, a natural enzyme, and floating electrode-dielectric barrier discharge (FE-DBD) plasma (1.1 kV, 43 kHz, N2 1.5 m/s) treatment, a non-thermal decontamination technology, against Escherichia coli biofilms in squid. E. coli (ATCC 35150 and ATCC 14301) biofilms were formed on the surface of squid and treated with different minimum inhibitory concentrations (MICs) of flavourzyme (1/8; 31.25 µL/mL, 1/4; 62.5 µL/mL, 2/4; 125 µL/mL, and 3/4 MIC; 250 µL/mL) and FE-DBD plasma (5, 10, 30, and 60 min). Independently, flavourzyme and FE-DBD plasma treatment decreased by 0.26-1.71 and 0.19-1.03 log CFU/cm2, respectively. The most effective synergistic combination against E. coli biofilms was observed at 3/4 MIC flavourzyme + 60 min FE-DBD plasma exposure, resulting in a reduction of 1.55 log CFU/cm2. Furthermore, the combined treatment exhibited higher efficacy in E. coli biofilm inactivation in squid compared to individual treatments. The pH values of the synergistic combinations were not significantly different from those of the untreated samples. The outcomes indicate that the combined treatment with flavourzyme and FE-DBD plasma can effectively provide effective control of E. coli biofilms without causing pH changes in squid. Therefore, our study suggests a new microbial control method for microbial safety in the seafood industry.
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The effective treatment and recovery of fracturing wastewater has always been one of the difficult problems to be solved in oilfield wastewater treatment. Accordingly, in this paper, photocatalytic-coupled low-temperature plasma technology was used to degrade the simulated wastewater containing hydroxypropyl guar, the main component of fracturing fluid. Results indicated that hydroxypropyl-guar wastewater could be degraded to a certain extent by either photocatalytic technology or plasma technology; the chemical oxygen demand and viscosity of the treated wastewater under two single-technique optimal conditions were 781 mg·L-1, 0.79 mPa·s-1 and 1296 mg·L-1, 1.01 mPa·s-1, respectively. Furthermore, the effective coupling of AgIn5S8/gC3N4 photocatalysis and dielectric-barrier discharge-low-temperature plasma not only enhanced the degradation degree of hydroxypropyl guar but also improved its degradation efficiency. Under the optimal conditions of coupling treatment, the hydroxypropyl-guar wastewater achieved the effect of a single treatment within 6 min, and the chemical oxygen demand and viscosity of the treated wastewater reduced to below 490 mg·L-1 and 0.65 mPa·s-1, respectively. In the process of coupled treatment, the AgIn5S8/gC3N4 could directly absorb the light and strong electric field generated by the system discharge and play an important role in the photocatalytic degradation, thus effectively improving the energy utilization rate of the discharge system and enhancing the degradation efficiency of hydroxypropyl guar.
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The remediation of diesel-contaminated soil is a critical environmental concern, driving the need for effective solutions. Recently, the methodology of Non-thermal Atmospheric Plasma (NTAP) technology, which is equipped with a Dielectric Barrier Discharge (DBD) electrode and has become a feasible approach, was proven to be viable. The reactive species from the plasma were exposed to the contaminated soil in this investigation using the NTAP technique. The reacted soil was then extracted using dichloromethane, and the amount of Total Petroleum Hydrocarbon (TPH) removed was assessed. Investigation into varying power levels, treatment durations, and hydrogen peroxide integration revealed significant findings. With an initial concentration of 3086 mg of diesel/kg of soil and a pH of 5.0, 83% of the diesel was removed from the soil at 150 W in under 20 min. Extended exposure to NTAP further improved removal rates, highlighting the importance of treatment duration optimization. Additionally, combining hydrogen peroxide (H2O2) with NTAP enhanced removal efficiency by facilitating diesel breakdown. This synergy offers a promising avenue for comprehensive soil decontamination. Further analysis considered the impact of soil characteristics on removal efficacy. Mechanistically, NTAP generates reactive species that degrade diesel into less harmful compounds, aiding subsequent removal. Overall, NTAP advances environmental restoration efforts by offering a quick, economical, and environmentally benign method of remediating diesel-contaminated soil especially when used in tandem with hydrogen peroxide.
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Recuperação e Remediação Ambiental , Gasolina , Peróxido de Hidrogênio , Gases em Plasma , Poluentes do Solo , Solo , Recuperação e Remediação Ambiental/métodos , Poluentes do Solo/análise , Gases em Plasma/química , Solo/química , Peróxido de Hidrogênio/química , Gasolina/análise , Petróleo/análise , Hidrocarbonetos/análiseRESUMO
In this study, 3,4,3',4'-tetrachlorobiphenyl (PCB77) contaminated soil was remediated by a fluidization bed dielectric barrier discharge (DBD) reactor and a fixed bed DBD reactor. The fluidized bed reactor could attain superior removal efficiency of PCB77 under same experimental parameters. In-situ discharge mode was more conducive to the degradation of PCB77 than ex-situ discharge mode due to short-lived active species existing in in-situ discharge. The influence of experimental parameters in the fluidized bed DBD reactor on the degradation of PCB77 were discussed such as electric features, gas features, soil features and initial PCB77 concentration. PCB77 removal efficiency in air discharge could reach 88.5 % after 8 min under the alkaline condition. Optical emission spectroscopy (OES) and quench tests showed that reactive oxygen species (ROS) and reactive nitrogen species (RNS) were generated in the discharge system and they both played a vital role in the degradation of PCB77. Scanning electron microscopy (SEM) results demonstrated that discharge had little effect on the morphology of soil particles. Energy dispersive spectrometer (EDS), ion chromatography (IC), and total organic carbon (TOC) results showed that the DBD could effectively mineralize and dechlorinate PCB77. The possible degradation pathway of PCB77 was inferred at the end based on the degradation products determined by gas chromatography-mass spectrometry (GC-MS).
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Atmospheric pressure dielectric barrier discharge (DBD) plasma is an emerging and promising technique for air disinfection in public environments. Power supply is a crucial factor but it remains unclear about its impacts on the air disinfection performance of plasmas. In this work, a nanosecond (ns) pulsed power supply was applied to drive an in-duct grating-like DBD array to achieve fast single-pass air disinfection. The influence of pulse parameters and environmental factors on both the discharge characteristics and the single-pass bacterial inactivation efficiency were uncovered. At a close relative humidity (RH) level, the efficiency was dominated by the discharge power, namely, specific input energy could serve as the disinfection dose. A higher frequency, shorter pulse rising time, and suitable pulse width are preferred to obtain a higher Z value. The pulsed source was not notably superior to an alternating current source, or even worse at a low voltage frequency at the same discharge power. Airflow humidity was a predominant factor to improve the efficiency and a single-pass efficiency of â¼ 99% and a Z value of 2.2 L/J were achieved under an optimal RH of 50%-60%. This work provides fundamental knowledge of ns-pulsed DBD on discharge characteristics and air disinfection behaviors.
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The enormous LysR-type transcriptional regulators (LTTRs), which are diversely distributed amongst prokaryotes, play crucial roles in transcription regulation of genes involved in basic metabolic pathways, virulence and stress resistance. However, the precise transcription activation mechanism of these genes by LTTRs remains to be explored. Here, we determine the cryo-EM structure of a LTTR-dependent transcription activation complex comprising of Escherichia coli RNA polymerase (RNAP), an essential LTTR protein GcvA and its cognate promoter DNA. Structural analysis shows two N-terminal DNA binding domains of GcvA (GcvA_DBD) dimerize and engage the GcvA activation binding sites, presenting the -35 element for specific recognition with the conserved σ70R4. In particular, the versatile C-terminal domain of α subunit of RNAP directly interconnects with GcvA_DBD, σ70R4 and promoter DNA, providing more interfaces for stabilizing the complex. Moreover, molecular docking supports glycine as one potential inducer of GcvA, and single molecule photobleaching experiments kinetically visualize the occurrence of tetrameric GcvA-engaged transcription activation complex as suggested for the other LTTR homologs. Thus, a general model for tetrameric LTTR-dependent transcription activation is proposed. These findings will provide new structural and functional insights into transcription activation of the essential LTTRs.
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RNA Polimerases Dirigidas por DNA , Escherichia coli , Ativação Transcricional , Escherichia coli/genética , Escherichia coli/metabolismo , RNA Polimerases Dirigidas por DNA/metabolismo , RNA Polimerases Dirigidas por DNA/química , RNA Polimerases Dirigidas por DNA/genética , Proteínas de Bactérias/química , Proteínas de Bactérias/metabolismo , Proteínas de Bactérias/genética , Regiões Promotoras Genéticas , Microscopia Crioeletrônica , Proteínas de Escherichia coli/química , Proteínas de Escherichia coli/metabolismo , Proteínas de Escherichia coli/genética , Fatores de Transcrição/química , Fatores de Transcrição/metabolismo , Fatores de Transcrição/genética , Modelos Moleculares , Simulação de Acoplamento Molecular , Regulação Bacteriana da Expressão Gênica , Multimerização Proteica , Sítios de LigaçãoRESUMO
Background: Mental, emotional, and behavioral disorders are chronic pediatric conditions, and their prevalence has been on the rise over recent decades. Affected children have long-term health sequelae and a decline in health-related quality of life. Due to the lack of a validated database for pharmacoepidemiological research on selected mental, emotional, and behavioral disorders, there is uncertainty in their reported prevalence in the literature. objectives: We aimed to evaluate the accuracy of coding related to pediatric mental, emotional, and behavioral disorders in a large integrated health care system's electronic health records (EHRs) and compare the coding quality before and after the implementation of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding as well as before and after the COVID-19 pandemic. Methods: Medical records of 1200 member children aged 2-17 years with at least 1 clinical visit before the COVID-19 pandemic (January 1, 2012, to December 31, 2014, the ICD-9-CM coding period; and January 1, 2017, to December 31, 2019, the ICD-10-CM coding period) and after the COVID-19 pandemic (January 1, 2021, to December 31, 2022) were selected with stratified random sampling from EHRs for chart review. Two trained research associates reviewed the EHRs for all potential cases of autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD), major depression disorder (MDD), anxiety disorder (AD), and disruptive behavior disorders (DBD) in children during the study period. Children were considered cases only if there was a mention of any one of the conditions (yes for diagnosis) in the electronic chart during the corresponding time period. The validity of diagnosis codes was evaluated by directly comparing them with the gold standard of chart abstraction using sensitivity, specificity, positive predictive value, negative predictive value, the summary statistics of the F-score, and Youden J statistic. κ statistic for interrater reliability among the 2 abstractors was calculated. Results: The overall agreement between the identification of mental, behavioral, and emotional conditions using diagnosis codes compared to medical record abstraction was strong and similar across the ICD-9-CM and ICD-10-CM coding periods as well as during the prepandemic and pandemic time periods. The performance of AD coding, while strong, was relatively lower compared to the other conditions. The weighted sensitivity, specificity, positive predictive value, and negative predictive value for each of the 5 conditions were as follows: 100%, 100%, 99.2%, and 100%, respectively, for ASD; 100%, 99.9%, 99.2%, and 100%, respectively, for ADHD; 100%, 100%, 100%, and 100%, respectively for DBD; 87.7%, 100%, 100%, and 99.2%, respectively, for AD; and 100%, 100%, 99.2%, and 100%, respectively, for MDD. The F-score and Youden J statistic ranged between 87.7% and 100%. The overall agreement between abstractors was almost perfect (κ=95%). Conclusions: Diagnostic codes are quite reliable for identifying selected childhood mental, behavioral, and emotional conditions. The findings remained similar during the pandemic and after the implementation of the ICD-10-CM coding in the EHR system.
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COVID-19 , Prestação Integrada de Cuidados de Saúde , Registros Eletrônicos de Saúde , Transtornos Mentais , Transtornos do Neurodesenvolvimento , Humanos , Criança , Registros Eletrônicos de Saúde/estatística & dados numéricos , Adolescente , Pré-Escolar , Masculino , COVID-19/epidemiologia , Feminino , Transtornos do Neurodesenvolvimento/epidemiologia , Transtornos do Neurodesenvolvimento/diagnóstico , Transtornos Mentais/epidemiologia , Transtornos Mentais/diagnóstico , Classificação Internacional de Doenças , Codificação ClínicaRESUMO
Introduction: Heart transplant remains the gold standard treatment for patients with advanced heart failure. However, the list of patients waiting for a heart transplant continues to increase. We have developed a portable hypothermic oxygenated machine perfusion device, the VP.S ENCORE®, to extend the allowable preservation time. The purpose of this study was to test the efficacy of the VP.S. ENCORE® using deceased donors derived hearts. Methods: Hearts from brain-dead donors not utilized for transplant (n = 11) were offered for research from the Texas Organ Sharing Alliance (TOSA), South and Central Texas' Organ Procurement Organization (OPO) and were preserved in the VP.S ENCORE® for 4 (n = 2), 6 (n = 3), and 8 (n = 3) hours or were kept in static cold storage (SCS) (n = 3). After preservation, the hearts were placed in an isolated heart Langendorff model for reperfusion and evaluated for cardiac function. Results: The mean donor age was 37.82 ± 12.67 with the youngest donor being 19 and the oldest donor being 58 years old. SCS hearts mean weight gain (%) was -1.4 ± 2.77, while perfused at 4â h was 5.6 ± 6.04, perfused at 6â h 2.1 ± 6.04, and 8â h was 7.2 ± 10.76. Venous and arterial lactate concentrations were less than 2.0â mmol/L across all perfused hearts. Left ventricular contractility (+dPdT, mmHg/s) for 4â h (1,214 ± 1,064), 6 (1,565 ± 141.3), and 8â h (1,331 ± 403.6) were within the range of healthy human heart function. Thus, not significant as compared to the SCS group (1,597 ± 342.2). However, the left ventricular relaxation (mmHg/s) was significant in 6-hour perfused heart (p < 0.05) as compared to SCS. Gene expression analysis of inflammation markers (IL-6, IL-1ß) showed no significant differences between SCS and perfused hearts, but a 6-hour perfusion led to a downregulated expression of these markers. Discussion: The results demonstrate that the VP.S ENCORE® device enhances cardiac viability and exhibits comparable cardiac function to a healthy heart. The implications of these findings suggest that the VP.S ENCORE® could introduce a new paradigm in the field of organ preservation, especially for marginal hearts.
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DBD low-temperature plasma (DLTP) is recognized as one of the most efficient technologies for treating cotton stalks. This study investigates the impact of various conditions on the gas production characteristics of cotton stalks (CS) and delves into the DLTP decomposition kinetics of CS and CSC in oxygen-enriched (30 % O2/Ar) and CO2 atmospheres. The decomposition rates of CS followed the order CO2 > N2 > Ar. The decomposition behavior of CSC in oxygen-enriched DLTP (30 % O2/Ar) aligned well with the chemical reaction model. The activation energies for CSC decomposition at 900 °C and 1000 °C were determined to be 23.8 kJ/mol and 33.8 kJ/mol, respectively. Moreover, the reaction rate decreased at higher carbonization temperatures, which proved to be detrimental to the decomposition of CSC. The DLTP decomposition of CSC in CO2 exhibited consistency with the fitting results of the unreacted shrinking core model, revealing an observed activation energy of 19.4 kJ/mol.
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Gossypium , Gases em Plasma , Gossypium/química , Cinética , Gases em Plasma/química , Dióxido de Carbono/química , Temperatura , Temperatura Baixa , Oxigênio/químicaRESUMO
By combining the advantages of dielectric barrier discharge (DBD) low temperature plasma and fluidized bed, the effect of plasma on the performance of supported Mo-based catalyst was studied in this paper. The performance of the catalyst obtained by plasma treatment, calcined, plasma+calcined was compared, and the appropriate catalyst preparation scheme was explored. Comparing with the three catalysts, it was concluded that the catalyst average conversion after 30â W plasma treatment is 33.40 %, which was 8.94 % and 12.75 % higher than the other two, respectively. The structure and properties of the catalyst were characterized by N2-Physisorption, H2-chemisorption, XRD, TEM, XPS, Raman and NO-pulse adsorption. Then, by analyzing the characterization results, it can be seen that plasma can make the catalyst have a higher specific surface area and a more dispersed active metal with smaller grain size. Through the surface species identification characterization, it was found that plasma can produce more defective structures and expose more active sites, which is the main reason for the difference in conversion.