Enhanced detection limit in an exceptional surface-based fiber resonator by manipulating Fano interference.

An exceptional surface (ES) has advantages in improving sensing robustness and enhancing frequency splitting. Typically, the eigenvalue splitting must exceed the mode linewidth in order to be clearly visible in the spectrum, which limits the precision of the ES-based sensing structure. In this paper, a strategy for manipulating spectral line shape in an ES-based structure is experimentally realized. In addition, the limit of the minimum detectable displacement can be further reduced by monitoring the peak intensity of the Fano interference line shape. The demonstration of Fano interference in an ES-based system opens the way for a new class of ultrasensitive optical sensors.

Artificial intelligence auxiliary diagnosis and treatment system for breast cancer in developing countries.

BACKGROUND: In many developing countries, a significant number of breast cancer patients are unable to receive timely treatment due to a large population base, high patient numbers, and limited medical resources. OBJECTIVE: This paper proposes a breast cancer assisted diagnosis system based on electronic medical records. The goal of this system is to address the limitations of existing systems, which primarily rely on structured electronic records and may miss crucial information stored in unstructured records. METHODS: The proposed approach is a breast cancer assisted diagnosis system based on electronic medical records. The system utilizes breast cancer enhanced convolutional neural networks with semantic initialization filters (BC-INIT-CNN). It extracts highly relevant tumor markers from unstructured medical records to aid in breast cancer staging diagnosis and effectively utilizes the important information present in unstructured records. RESULTS: The model's performance is assessed using various evaluation metrics. Such as accuracy, ROC curves, and Precision-Recall curves. Comparative analysis demonstrates that the BC-INIT-CNN model outperforms several existing methods in terms of accuracy and computational efficiency. CONCLUSIONS: The proposed breast cancer assisted diagnosis system based on BC-INIT-CNN showcases the potential to address the challenges faced by developing countries in providing timely treatment to breast cancer patients. By leveraging unstructured medical records and extracting relevant tumor markers, the system enables accurate staging diagnosis and enhances the utilization of valuable information.

Bioinspired Tetranuclear Manganese Cubane Complex as an Efficient Molecular Electrocatalyst for Two-Electron Water Oxidation Towards Hydrogen Peroxide.

Stable homogeneous two-electron water oxidation electrocatalysts are highly demanded to understand the precise mechanism and reaction intermediates of electrochemical H2O2 production. Here we report a tetranuclear manganese complex with a cubane structure which can electrocatalyze water oxidation to hydrogen peroxide under alkaline and neutral conditions. Such a complex demonstrates an optimal Faradaic efficiency (FE) of 87 %, which is amongst (if not) the highest FE(H2O2) of reported homogeneous and heterogeneous electrocatalysts. In addition, active species were identified and co-catalysts were excluded through ESI-MS characterization. Furthermore, we identified water binding sites and isolated one-electron oxidation intermediate by chemical oxidation of the catalyst in the presence of water substrates. It is evident that efficient proton-accepting electrolytes avoid rapid proton building-up at electrode and substantially improve reaction rate and selectivity. Accordingly, we propose a two-electron catalytic cycle model for water oxidation to hydrogen peroxide with the bioinspired molecular electrocatalyst. The present work is expected to provide an ideal platform to elucidate the two-electron WOR mechanism at the atomic level.

Visualization of Lysosomal Dynamics during Autophagy by Fluorescent Probe.

Lysosomes are one of the important organelles within cells, and their dynamic movement processes are associated with many biological events. Therefore, real-time monitoring of lysosomal dynamics processes has far-reaching implications. A lysosome-targeted fluorescent probe N(CH2)3-BD-PZ is proposed for real-time monitoring of lysosomal kinetic motility. Using this probe, the dynamic process of lysosomes under starvation induction was successfully explored through fluorescence imaging. Importantly, we observed a new pattern of lysosomal dynamic movement, in which an irregular lysosome was slowly cleaved into two different-sized touching lysosomes and then fused to form a new round lysosome. This research provides a powerful fluorescence tool to understand the dynamic motility of intracellular lysosomes under fluorescence imaging.

Missense mutation of c.635 T > C in CAPN3 impairs muscle injury repair in a Limb-Girdel Muscular Dystropy Model.

Limb-girdle muscular dystrophy recessive 1 (LGMDR1), previously known as LGMD2A, is a specific LGMD caused by a gene mutation encoding the calcium-dependent neutral cysteine protease calpain-3 (CAPN3). In our study, the compound heterozygosity with two missense variants c.635 T > C (p.Leu212Pro) and c.2120A > G (p.Asp707Gly) was identified in patients with LGMDR1. However, the pathogenicity of c.635 T > C has not been investigated. To evaluate the effects of this novel likely pathogenic variant to the motor system, the mouse model with c.635 T > C variant was prepared by CRISPR/Cas9 gene editing technique. The pathological results revealed that a limited number of inflammatory cells infiltrated the endomyocytes of certain c.635 T > C homozygous mice at 10 months of age. Compared with wild-type mice, motor function was not significantly impaired in Capn3 c. 635 T > C homozygous mice. Western blot and immunofluorescence assays further indicated that the expression levels of the Capn3 protein in muscle tissues of homozygous mice were similar to those of wild-type mice. However, the arrangement and ultrastructural alterations of the mitochondria in the muscular tissues of homozygous mice were confirmed by electron microscopy. Subsequently, muscle regeneration of LGMDR1 was simulated using cardiotoxin (CTX) to induce muscle necrosis and regeneration to trigger the injury modification process. The repair of the homozygous mice was significantly worse than that of the control mice at day 15 and day 21 following treatment, the c.635 T > C variant of Capn3 exhibited a significant effect on muscle regeneration of homozygous mice and induced mitochondrial damage. RNA-sequencing results demonstrated that the expression levels of the mitochondrial-related functional genes were significantly downregulated in the mutant mice. Taken together, the results of the present study strongly suggested that the LGMDR1 mouse model with a novel c.635 T > C variant in the Capn3 gene was significantly dysfunctional in muscle injury repair via impairment of the mitochondrial function.

Knowledge about schizophrenia test: the Chinese Mandarin version and its sociodemographic and clinical factors.

BACKGROUND: Schizophrenia is a chronic, complex, and severe mental disorder and caregivers having knowledge about it can help improve patient adherence to treatment. This study aims to translate the Knowledge About Schizophrenia Test (KAST) into a Chinese Mandarin version and test it among caregivers to validate its reliability and reproducibility, as well as to determine its associated sociodemographic factors and clinical factors. METHODS: The project surveyed 160 patients with schizophrenia and their caregivers at four community health facilities in Beijing, China, from January 2022 to February 2022. All patients and caregivers completed the sociodemographic questionnaire, and caregivers also completed the Chinese-version KAST, and 143 of these caregivers completed the Chinese-version KAST again 2-4 weeks later. RESULTS: The mean (SD) of the caregiver score was 11.49 (± 3.13). After item analysis, there was acceptable internal consistency among the 17 items in the Chinese version (KR-20 coefficient 0.702). The intraclass correlation coefficient in the retest (0.686) was statistically significant. Gender, educational attainment, marital status, relationship with the patient, and occupational status were associated with the KAST score. CONCLUSION: The findings demonstrate that the Chinese-version KAST is a reliable and reproducible instrument that can measure knowledge about schizophrenia and is valid to be applied in schizophrenia research.

Physical activity and eating behaviors patterns associated with high blood pressure among Chinese children and adolescents.

BACKGROUND: Physical activity and eating behavior are associated with hypertension in children and adolescents. Revealing the associations between physical activity patterns, eating behavior patterns and high blood pressure (HBP) could help improve the problem of hypertension from the actual children's physical activities and eating behaviors. METHODS: A total of 687 students aged 8-15 years were selected from two nine-year primary and secondary schools using stratified cluster random sampling method. The students' body height, weight, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured, and their physical activity time and eating behaviors were surveyed by using CLASS questionnaire and self-made eating behavior questionnaire, respectively. Exploratory factor analysis (EFA) was used to extract moderate to vigorous physical activity factor (MVPAF), sedentary activity factor (SAF), healthy eating behavior factor (HEBF), unhealthy eating behavior factor (UHEBF). MVPAF ≥ SAF was defined as moderate to vigorous physical activity pattern (MVPAP), MVPAF < SAF was defined as sedentary activity pattern (SAP). HEBF ≥ UHEBF was defined as healthy eating behavior pattern (HEBP), while the opposite was defined as unhealthy eating behavior pattern (UHEBP). Lifestyles includes physical activity patterns and eating behavior patterns. RESULTS: The overall prevalence of hypertension was 5.8% (40/687), and was 5.69% (21/369) in boys and 5.97% (19/318) in girls, respectively. The MVPAF and UHEBF in boys were significantly higher than those in girls (P < 0.01), while the SAF in girls was significantly higher than that in boys (P < 0.05). The SAF was positively correlated with SBP in girls (ß(SE) = 0.14 (0.50), P = 0.016), and was positively correlated with SBP (ß(SE) = 0.21 (1.22), P = 0.000 and DBP (ß(SE) = 0.14 (0.49), P = 0.006) in boys. The MVPAF was negatively correlated with DBP (ß(SE)=-0.11 (0.40), P = 0.022) in boys. In boys, the SAP increased the risks of HBP (OR (95% CI):3.34 (1.30-8.63)) and high DBP (OR (95% CI):3.08 (1.02-9.34)) compared with MVPAP. CONCLUSION: Compared with the boys with MVPAP, boys with SAP may increase the risks of HBP and high DBP. The SAF may be positively associated with SBP in boys and girls, while the MVPAF may be negatively associated with DBP in boys.

Preparation of Fe/Ni-MOFs for the Adsorption of Ciprofloxacin from Wastewater.

This work studies the use of Fe/Ni-MOFs for the removal of ciprofloxacin (CIP) in wastewater. Fe/Ni-MOFs are prepared by the solvothermal method and characterized by X-ray diffraction (XRD), a scanning electron microscope (SEM), Fourier transform infrared spectroscopy (FT-IR), and a thermal gravimetric analyzer (TG). Under the conditions of the concentration of 50 ppm, a mass of 30 mg, and a temperature of 30 °C, the maximum adsorption capacity of ciprofloxacin removal within 5 h was 232.1 mg/g. The maximum removal rate was 94.8% when 40 mg of the Fe/Ni-MOFs was added to the solution of 10 ppm ciprofloxacin. According to the pseudo-second-order (PSO) kinetic model, the R2 values were all greater than 0.99, which proved that the adsorption theory of ciprofloxacin by Fe/Ni-MOFs was consistent with the practice. The adsorption results were mainly affected by solution pH and static electricity, as well as other factors. The Freundlich isotherm model characterized the adsorption of ciprofloxacin by Fe/Ni-MOFs as multilayer adsorption. The above results indicated that Fe/Ni-MOFs were effective in the practical application of ciprofloxacin removal.

Novel Polarity Fluorescent Probe for Dual-Color Visualization of Lysosomes and Plasma Membrane during Apoptosis.

Apoptosis plays a crucial role in the occurrence of cancer and other diseases. Real-time monitoring of the cell apoptosis process has great significance for cell viability and drug screening. Herein, a novel fluorescent probe was constructed based on the fluorescence resonance energy transfer mechanism, which track the sensitivity of polarity changes, as well as detect the drug-induced cell apoptosis process in a dual-color mode. Importantly, the change of cellular microenvironmental polarity makes it possible to dynamically visualize the process of drug-induced cell apoptosis. More significantly, the designed probe targeted the lysosomes in the living cells to give a blue emission, and it accumulated on the plasma membrane to display red fluorescence during the drug-induced cell apoptosis process. Thus, cell viability could be monitored by both the localization and emission colors of the robust probe. We expect that the unique probe can provide a new blueprint for evaluating and screening apoptosis-related drugs.

Activatable Fluorescent-Photoacoustic Integrated Probes with Deep Tissue Penetration for Pathological Diagnosis and Therapeutic Evaluation of Acute Inflammation in Mice.

Inflammation is associated with many diseases, so the development of an excellent near infrared fluorescent (NIRF) and photoacoustic (PA) dual-modality probe is crucial for the accurate diagnosis and efficacy evaluation of inflammation. However, most of the current NIRF/PA scaffolds are based on repurposing existing fluorescent dye platforms that exhibit non-optimal properties for both NIRF and PA signal outputs. Herein, we developed a novel dye scaffold QL-OH by optimizing the NIRF and PA signal of classical hemicyanine dyes. Based on this optimized dye, we developed the first NIRF/PA dual-mode carbon monoxide (CO) probe QL-CO for noninvasive and sensitive visualization of CO levels in deep inflammatory lesions in vivo. The novel probe QL-CO exhibited rapid and sensitive NIRF775/PA730 dual activation responses toward CO. In addition, the CO-activated probe QL-CO was successfully used for the diagnosis of inflammation and evaluation of anti-inflammation drug efficacy in living mice though the NIRF/PA dual-mode imaging technology for the first time. More importantly, the probe QL-CO could accurately locate the deep inflammatory lesion tissues (≈1 cm) in mice and obtain 3D PA diagnostic images with deep penetration depth and spatial resolution. Therefore, the new NIRF/PA dual-mode probe QL-CO has high potential for deep-tissue diagnosis imaging of CO in vivo. These findings may provide a new tool and approach for future research and diagnosis of CO-associated diseases.

[Genetic diversity and population structure of germplasm resources of Amomum villosum based on SSR markers].

Amomum villosum, serving as an important medicinal material, is complex in the genetic background of germplasm resources. Exploring the genetic diversity and genetic relationship of germplasm resources is conducive to clarifying the germplasm source and genetic background of A. villosum, so as to improve the efficiency of parent selection and variety breeding of A. villosum. Seventy-one pairs of SSR primers were used for PCR amplification of 84 A. villosum samples by polyacrylamide gel electrophoresis. Fifty-four pairs of SSR primers with high polymorphism were screened out for the analysis of genetic diversity. The results showed that 293 alleles were detected from 84 germplasm resources by 54 pairs of SSR primers, with an average of 5.32 alleles for each pair of primers, and a variation range of 3-8, and the primer AVL12 marked the highest number of alleles. The PIC value of each locus varied from 0.068 7 to 0.828 9, with an average of 0.529 9, and the highest was marked by AVL24. The genetic diversity of A. villosum was the highest in Yunnan, followed by Guangxi, and the lowest was found in Guangdong. The population structure analysis and cluster analysis showed that the samples were classified into two groups. In terms of origin, samples from Yunnan and Guangxi had a close genetic relationship, and there was no obvious differentiation of A, villosum resources from different origins. In this study, 54 pairs of SSR markers were used to analyze the genetic diversity and population structure of 84 germplasm resources, which can reflect the genetic relationship between A. villosum samples from different germplasm sources and different populations, thus providing a theoretical basis for the collection, research, and breeding of A. villosum resources.

Activatable Photoacoustic Probe for In Situ Imaging of Endogenous Carbon Monoxide in the Murine Inflammation Model.

Photoacoustic (PA) imaging is an emerging biomedical imaging modality that combines the advantages of optical and ultrasound imaging. Carbon monoxide (CO), which is a vital endogenous cell-signaling molecule in the human body, exerts critical physiological functions such as anti-inflammatory, antiapoptotic, and antiproliferative. The imbalance of CO homeostasis is also associated with numerous diseases. Therefore, it is critically important to noninvasively monitor the steady-state changes of CO in vivo. However, the activatable photoacoustic (PA) probes for detecting CO-associated complicated diseases have not yet developed. In this work, we developed the first turn-on PA probe (MTR-CO) to visualize the CO level in the lipopolysaccharide (LPS)-induced acute inflammation murine model through PA imaging technology. MTR-CO is composed of a near-infrared absorption cyanine-like dye (MTR-OH) and allyl formate, showing a 10.2-fold PA signal enhancement at 690 nm upon activation by CO. Furthermore, the results revealed that MTR-CO has high sensitivity, excellent specificity, and good biocompatibility for CO in vivo. MTR-CO was then applied for PA imaging of CO in cells and for monitoring the development of acute inflammation in the murine model by tracking the changes of the CO level. These findings provide a promising strategy for accurately detecting the steady-state changes of CO in living organisms.

Aging Diagnostic Probe for Research on Aging and Evaluation of Anti-aging Drug Efficacy.

Aging is a biological process, and its gradual degeneration of physiological functions leads to an increase in morbidity and mortality. At present, more and more studies on aging and anti-aging drugs have been conducted, which are of great significance for promoting human health, treating aging-related diseases, and prolonging human life. In the process of aging research and evaluation of anti-aging drugs, ß-galactosidase, as an important criterion of aging, has received extensive attention. However, there is a scarcity of effective and reliable tools for aging research and anti-aging drug evaluation based on the aging markers. Hence, we developed a new highly sensitive fluorescent probe, YDGAL, for ß-galactosidase, which exhibited good affinity for ß-gal (Km = 12.35 µM), fast response speed (stable within 10 min), and extremely low detection limit (2.185 × 10-6 U/mL). Owing to the above advantages, the robust probe can visualize aging and evaluate the efficacy of anti-aging drugs at the cellular and organ levels by detecting ß-galactosidase. Through visual imaging of mouse organs, we found that the organs had different degrees of aging; dasatinib and quercetin combination therapy had a therapeutic effect on the mice, but the different organs showed distinct clearance rates on the senescent cells, which may be the limitation of the drugs. We believe that this interesting finding could provide a powerful guidance for the research on aging and the evaluation of anti-aging drugs in the future.

Giant and tunable Goos-Hänchen shift with a high reflectance induced by PT-symmetry in atomic vapor.

The Goos-Hänchen (GH) shifts of light beams reflected from conventional passive optical systems could be enhanced using the Brewster angle effect or resonance effect, but the maximum GH shift is located at the reflectance minima, which is difficult for experimental detection. In this paper, we present an efficient and flexible scheme to realize complex parity-time (PT)-symmetric periodic optical potentials (complex crystals) in helium atomic vapor. The GH shifts of probe light reflected from the complex crystal are theoretically investigated and large GH shifts could be obtained inside the high-reflection band. When the complex crystal is operated near the coherent perfect absorption-laser point, the maximum GH shift of probe light is exactly located at the reflectance peak. Moreover, the GH shifts could be easily controlled by adjusting the intensity of control light.

Ecotoxicity evaluation of azoxystrobin on Eisenia fetida in different soils.

Azoxystrobin, a widely used broad-spectrum strobilurin fungicide, may pose a potential threat in agricultural ecosystems. To assess the ecological risk of azoxystrobin in real soil environments, we performed a study on the toxic effects of azoxystrobin on earthworms (Eisenia fetida) in three different natural soils (fluvo-aquic soil, black soil and red clay soil) and an artificial soil. Acute toxicity of azoxystrobin was determined by filter paper test and soil test. Accordingly, exposure concentrations of chronic toxicity were set at 0, 0.1, 1.0 and 2.5 mg kg-1. For chronic toxicity test, reactive oxygen species, activity of antioxidant enzymes (superoxide dismutase, catalase and peroxidase), detoxifying enzyme (glutathione transferase), level of lipid peroxidation (malondialdehyde) and level of oxygen damage of DNA (8-hydroxydeoxyguanosine) in earthworms were determined on the 7th, 14th, 21st, 28th, 42nd and 56th days after treatment. Both acute and chronic toxic results showed azoxystrobin exhibit higher toxicity in natural soil than in artificial soil, indicating that traditional artificial soil testing method underestimate ecotoxicity of azoxystrobin in a real agricultural environment on the earthworm population. Combining with the analysis of soil physicochemical properties, the present experiment provided scientific guidance for rational application of azoxystrobin in agricultural production systems.

Surgical repair of subaortic stenosis resection: 10 years of single-center experience in 65 patients.

BACKGROUND: Subaortic stenosis (SAS) was a rare congenital heart disease of left ventricular outflow tract (LVOT), ranging from "isolated" lesions to "tunnel" or "diffuse" lesions. We conducted a retrospective study to describe the characteristics of patients with different lesions and analyze the risk factors for reoperation. METHODS: In this study, we examined a single-center retrospective cohort of SAS patients undergoing resection from 2010 to 2019. Patients were classified as simple lesion group (n = 37) or complex lesion group (n = 28). Demographics, perioperative findings, and clinical data were analyzed. RESULTS: The surgical effect of the two groups was significantly lower than that before the operation (p < .05). The median age at operation was 6 (3-11.8) years. There was no operative mortality. In complex lesion group, cardiopulmonary bypass time (CPB time), aortic cross-clamping time (ACC time), mechanical ventilation time, and intensive care unit (ICU) stay time were longer. The median follow-up period was 2.8 years (range: 1-3.8), with two late death. Six patients (9.2%) required reoperation due to restenosis or severe aortic insufficiency. The freedom from reoperation rates at 5 years was 66.7% for simple lesion but only 52.3% for complex lesion (p = .036). CONCLUSIONS: Although the lesions include many forms, SAS resection was still satisfactory. However, the reoperation after initial surgical treatment was not infrequent, especially in patients with complex lesion.

HTRA1 rs11200638 variant and AMD risk from a comprehensive analysis about 15,316 subjects.

BACKGROUND: The high-temperature requirement factor A1 (HTRA1) gene located at 10q26 locus has been associated with age-related macular degenerative (AMD), with the significantly related polymorphism being (rs11200638, -625G/A), however, above association is not consistent. We investigated a comprehensive analysis to evaluate the correlations between rs11200638 polymorphism and AMD susceptibility thoroughly addressing this issue. METHODS: An identification was covered from the PubMed and Wanfang databases until 27th Jan, 2020. Odds ratios (OR) with 95% confidence intervals (CI) were applied to evaluate the associations. After a thorough and meticulous search, 35 different articles (33 case-control studies with HWE, 22 case-control studies about wet/dry AMD) were retrieved. RESULTS: Individuals carrying A-allele or AA genotype may have an increased risk to be AMD disease. For example, there has a significantly increased relationship between rs11200638 polymorphism and AMD both for Asians (OR: 2.51, 95%CI: 2.22-2.83 for allelic contrast) and Caucasians [OR (95%CI) = 2.63(2.29-3.02) for allelic contrast]. Moreover, a similar trend in the source of control was detected. To classify the type of AMD, increased association was also observed in both wet (OR: 3.40, 95%CI: 2.90-3.99 for dominant model) and dry (OR: 2.08, 95%CI: 1.24-3.48 for dominant model) AMD. Finally, based on the different genotyping methods, increased relationships were identified by sequencing, TaqMan, PCR-RFLP and RT-PCR. CONCLUSIONS: Our meta-analysis demonstrated that HTRA1 rs11200638 polymorphism may be related to the AMD development, especially about individuals carrying A-allele or AA genotype, who may be as identified targets to detect and intervene in advance. Further studies using Larger sample size studies, including information about gene-environment interactions will be necessary to carry out.

[Male infertility - related gene knockout mouse models].

The pathogenesis of male infertility is rather complicated. The establishment of animal models, especially mouse models, of male infertility, provides a model basis for the studies of the roles and molecular mechanisms of infertility-related genes. Currently there are mainly three types of mouse models for biomedical researches, namely, the mouse model made by the knockout, knock-in or gene capture method, transgenic mouse model, and chemically induced point mutant mouse model. This review summarizes male infertility - related gene knockout mouse models, aiming to find a suitable animal model for studying the pathogenesis of male infertility.

Synthesis and Magnetic Properties of Ferroferric Oxide in Supercritical Methanol.

Ferroferric oxide was prepared using Fe(NO3)3 · 9H2O as the iron source under supercritical methanol conditions. Methanol was not only a solvent but also a reducing agent in the supercritical state. The effects of reaction temperature and time, and precursor concentration on product composition were investigated. In addition, ferromagnetic ferroferric oxide was synthesized in supercritical methanol with polyvinyl pyrrolidone (PVP) and polyethylene glycol (PEG) as surfactants. The as-synthesized products were characterized by XRD, SEM, FTIR techniques. Results showed that the addition of PVP and PEG had notable influences on the products. The findings also showed that ferroferric oxide of a loose flocculent structure and with a variable size (from several tens to a few hundred nanometers) had been prepared in supercritical methanol at 300 °C and 17.8 MPa for 15 min. Magnetic properties of the ferroferric oxide were detected by vibrating sample magnetometer. Its saturation magnetization was 50 emu/g, which was lower than the bulk value of 92 emu/g and showed that it had ferromagnetism.

Prenatal Diagnosis of Aortopulmonary Window by 2-Dimensional Echocardiography: Summary of 8 Cases.

Aortopulmonary window (APW) is a rare congenital heart anomaly. A total of 8 cases with APW confirmed by echocardiography and surgery were retrospectively reviewed and the echocardiographic features analyzed. Among the 8 APW cases, 5 were type II and 3 were type III, the latter of which includes 2 cases complicated with Berry syndrome. Prenatal echocardiography can provide accurate information for the diagnosis of fetal APW. The prognosis depends on the timing of surgery and the nature of the associated cardiac anomalies.