Polarization-Diversity Optical Coherence Tomography Assessment of Choroidal Nevi.

Purpose: The purpose of this study was to demonstrate the utility of polarization-diversity optical coherence tomography (PD-OCT), a noninvasive imaging technique with melanin-specific contrast, in the quantitative and qualitative assessment of choroidal nevi. Methods: Nevi were imaged with a custom-built 55-degree field-of-view (FOV) 400 kHz PD-OCT system. Imaging features on PD-OCT were compared to those on fundus photography, auto-fluorescence, ultrasound, and non-PD-OCT images. Lesions were manually segmented for size measurement and metrics for objective assessment of melanin distributions were calculated, including degree of polarization uniformity (DOPU), attenuation coefficient, and melanin occupancy rate (MOR). Results: We imaged 17 patients (mean age = 69.5 years, range = 37-90) with 11 pigmented, 3 non-pigmented, and 3 mixed pigmentation nevi. Nevi with full margin acquisition had an average longest basal diameter of 5.1 mm (range = 2.99-8.72 mm) and average height of 0.72 mm (range = 0.37 mm-2.09 mm). PD-OCT provided clear contrast of choroidal melanin content, distribution, and delineation of nevus margins for melanotic nevi. Pigmented nevi were found to have lower DOPU, higher attenuation coefficient, and higher MOR than non-pigmented lesions. Melanin content on PD-OCT was consistent with pigmentation on fundus in 15 of 17 nevi (88%). Conclusions: PD-OCT allows objective assessment of choroidal nevi melanin content and distribution. In addition, melanin-specific contrast by PD-OCT enables clear nevus margin delineation and may improve serial growth surveillance. Further investigation is needed to determine the clinical significance and prognostic value of melanin characterization by PD-OCT in the evaluation of choroidal nevi.

Mitigation strategies for excessive cadmium in rice.

Cadmium (Cd)-contaminated rice is a human food safety problem that lacks a clear solution. A large amount of rice having an excessive Cd content is processed yearly, but it cannot be discarded and placed in landfills because it will cause secondary pollution. How do we best cope with this toxic rice? From the perspectives of food safety, food waste prevention, and human hunger eradication, the use of contemporary physical, chemical, and biological techniques to lower the Cd content in postharvest Cd-contaminated rice so that it can be used safely is the best course of action. In this review, the contamination, chemical speciation, and distribution of Cd in rice are analyzed and discussed, as are the methods of Cd removal from rice, including a comparison of the advantages and disadvantages of various techniques. Owing to the limitations of current technology, research and technological development recommendations for removing Cd from rice grain are presented. The chemical and biological methods produce higher Cd-removal rates than physical methods. However, they are limited to small-scale laboratory applications and cannot be applied on a large industrial scale. For the efficient safe removal of Cd from food, mixed fermentation with lactic acid bacteria and yeast has good application prospects. However, limited strains having high Cd-removal rates have been screened. In addition, modern biotechnology has rarely been applied to reduce rice Cd levels. Therefore, applying genetic engineering techniques to rapidly obtain microorganisms with high Cd-removal rates in rice should be the focus of future research.

Fabrication of a LiNi0.5Mn0.4Ti0.03Mg0.03Nb0.01Mo0.03O2 cathode for low-cost long-life lithium-ion batteries.

The high price of Co and Ni restricts the development of the lithium-ion battery industry. Reducing the Ni content and eliminating Co is an effective way to lower the cost. In this work, we eliminate the Co in NCM523 cathodes by using a complex concentrated doping strategy. LiNi0.5Mn0.4Ti0.03Mg0.03Nb0.01Mo0.03O2 shows an unparalleled cost advantage with relatively high specific energy (>720 W h kg-1) and significantly improved overall performance (96% capacity retained after 1000 cycles). This report offers an important pathway to fabricate cathode materials for low-cost and long-life LIBs.

Co-Design of Adaptive Event Generator and Asynchronous Fault Detection Filter for Markov Jump Systems via Genetic Algorithm.

This article investigates the co-design problem of adaptive event-triggered schemes (AETSs) and asynchronous fault detection filter (AFDF) for nonhomogeneous higher-level Markov jump systems, involving the hidden Markov model (HMM), higher-level Markov chain (MC), and conic-type nonlinearities. The transformation of the system transition probability can be reflected by the designed higher-level MC. An HMM with another conditional transition probability is applied to detect higher-level Markov processes and make the system be more practical. In order to balance the utilization of network resources and system performance, a novel AETS is proposed and used in the construction of the AFDF. By the Lyapunov theory, sufficient conditions are given to ensure the existences of the AETS and AFDF. It is not only an appropriate tradeoff between the utilization of network resources and system performance, but also reduces the conservatism. Finally, a numerical example is given to detect the faults effectively by the co-designed AFDF.

Towards a global One Health index: a potential assessment tool for One Health performance.

BACKGROUND: A One Health approach has been increasingly mainstreamed by the international community, as it provides for holistic thinking in recognizing the close links and inter-dependence of the health of humans, animals and the environment. However, the dearth of real-world evidence has hampered application of a One Health approach in shaping policies and practice. This study proposes the development of a potential evaluation tool for One Health performance, in order to contribute to the scientific measurement of One Health approach and the identification of gaps where One Health capacity building is most urgently needed. METHODS: We describe five steps towards a global One Health index (GOHI), including (i) framework formulation; (ii) indicator selection; (iii) database building; (iv) weight determination; and (v) GOHI scores calculation. A cell-like framework for GOHI is proposed, which comprises an external drivers index (EDI), an intrinsic drivers index (IDI) and a core drivers index (CDI). We construct the indicator scheme for GOHI based on this framework after multiple rounds of panel discussions with our expert advisory committee. A fuzzy analytical hierarchy process is adopted to determine the weights for each of the indicators. RESULTS: The weighted indicator scheme of GOHI comprises three first-level indicators, 13 second-level indicators, and 57 third-level indicators. According to the pilot analysis based on the data from more than 200 countries/territories the GOHI scores overall are far from ideal (the highest score of 65.0 out of a maximum score of 100), and we found considerable variations among different countries/territories (31.8-65.0). The results from the pilot analysis are consistent with the results from a literature review, which suggests that a GOHI as a potential tool for the assessment of One Health performance might be feasible. CONCLUSIONS: GOHI-subject to rigorous validation-would represent the world's first evaluation tool that constructs the conceptual framework from a holistic perspective of One Health. Future application of GOHI might promote a common understanding of a strong One Health approach and provide reference for promoting effective measures to strengthen One Health capacity building. With further adaptations under various scenarios, GOHI, along with its technical protocols and databases, will be updated regularly to address current technical limitations, and capture new knowledge.

Study on the Mental Health of the Elderly under Different Pension Models.

OBJECTIVE: To compare the mental health status of the elderly under different pension modes and to provide evidence for improving institutional services and the quality of life of the elderly. METHODS: A total of 118 elderly people in social welfare homes, nursing homes, and elderly welfare centers in D city and 165 elderly people from families in D city were assessed by self-made questionnaire, Geriatric Depression Scale (GDS), activities of daily living scale (ADL), and social support rating scale (SSRS). RESULTS: The total scores of mental health and self, emotion, and adaptation subscales in the social group were higher than those in the home group, with a significant difference (p > 0.05). The scores of cognitive and interpersonal subscales in the home group were higher than those in the social group, but the differences were not significant (p > 0.05). Under the mode of family pension and social institution pension, the health status of the elderly has certain differences. The elderly in different old-age care modes have good performance in diet and sleep, and there is no statistical difference between them (p > 0.05). CONCLUSION: The investigation shows that the mental health status of the elderly under the family pension model is obviously better than that under the social institution pension model.

Muscle thickness assessment of the forearm via ultrasonography: is experience level important?

It is suggested that experience is needed in order to capture valid estimates of muscle size with ultrasound. However, it is unknown whether there is a large degree of skill needed to analyze the images once they are captured.Objective.To determine if less experienced raters could accurately analyze ultrasound images of the forearm by comparing their estimates with those of a very experienced ultrasonographer (criterion).Approach.50 muscle thickness images were captured by one experienced ultrasonographer (also Rater 1). Those images were saved and were then measured by four raters with different levels of experience. The rater who captured the images was very experienced (criterion), the second rater was also experienced and provided 5 minutes of instruction for Rater 3 (minimal experience) and Rater 4 (no experience). Test-retest reliability was also determined for Rater 3 and 4.Main Results.The average muscle thickness value for the criterion was 3.73 cm. The constant error for Rater 2, 3, and 4 was -0.003 (0.02) cm (p= 0.362), -0.07 (0.04) cm (p< 0.001), and 0.02 (0.09) cm (p= 0.132), respectively. The SD for Rater 4 was greater, resulting in wider limits of agreement compared to Rater 2 and 3. Absolute error was 0.01 cm for Rater 2, whilst it was 0.07 cm and 0.03 cm for the two inexperienced raters (Rater 3 and 4). The error for Rater 3 was systematic and post-hoc assessment found that this rater was using a different border than the other three raters (but consistent across time). For the test-retest reliability, the minimal difference for Rater 3 was 0.08 cm (relative minimal difference of 2%) and 0.17 cm (relative minimal difference of 4%) for Rater 4.Significance.Less experienced raters were able to accurately and reliably analyze already captured muscle thickness images of the forearm with low absolute errors.

Humerus trochlear angle (HTa)-a possible alternative for Baumann angle in the reduction of supracondylar humerus fractures.

BACKGROUND: The supracondylar humerus fractures are the most common fracture in children's elbows. Generally, close reduction and percutaneous pinning can provide satisfactory outcomes after adequate reduction. Baumann angle is commonly used to evaluate reduction quality, however, it may fail to assess reduction well when the elbow is in flexion and/or when the patient is young. We conducted this study to evaluate the potential value of the humerus trochlear angle (HTa) for the reduction evaluation and compare it with the Baumann angle. METHODS: We retrospectively reviewed supracondylar humerus fractures in our trauma center from 2016 to 2019. Patients were grouped as followed: in the HTa group, an arthrogram was used to evaluate the HTa angle and reduction (HTa, defined by the intersection of the axis of the humerus shaft and the tangent of the articular surface of the trochlear); In the Baumann group, the Baumann angle was used to assess the reduction. Baumann angle ratio (BA of injured side/BA of contralateral side) was calculated to evaluate the reduction quality between groups. Flynn's grading criteria were utilized to evaluate both function and cosmetic outcomes in two groups during the follow-up. Operation time, fluoroscopy shots, complications and Flynn's grading scores were compared between groups. RESULTS: A total of 57 patients with an average age of 4.62 years and follow-up duration of 21.49 ± 5.40 months were included in the analysis. The gender and age distributions were similar in the two groups. Fluoroscopy shots in the HTa group were significantly less than in Baumann group (16.17 ± 0.73 vs. 21.85 ± 0.78, p < 0.0001), and operation time were also less in HTa group (45.78 ± 1.96 min vs. 62.21 ± 1.58 min, p < 0.0001). Baumann ratio showed no significant difference between the two groups (1.002 ± 0.023 in the Baumann group and 1.01 ± 0.023 in HTa group, p < 0.0001). Length of hospitalization, complications, and Flynn's grading scores were similar between groups. The HTa angle was positively correlated with Baumann angle in the HTa group (R-value is 0.71 and P = 0.0002). CONCLUSIONS: There was no significant difference in reduction quality and Flynn's scores between HTa and Baumann groups. Furthermore, HTa was associated with shorter operation time and less radiation exposure in this investigation. Therefore, HTa may be a convenient and reliable parameter that could guide the reduction of supracondylar humerus fractures, especially for young children.

Genetic-Algorithm-Assisted Sliding-Mode Control for Networked State-Saturated Systems Over Hidden Markov Fading Channels.

The sliding-mode control (SMC) problem is studied in this article for state-saturated systems over a class of time-varying fading channels. The underlying fading channels, whose channel fading amplitudes (characterized by the expectation and variance) are allowed to be different, are modeled as a finite-state Markov process. A key feature of the problem addressed is to use a hidden Markov mode detector to estimate the actual network mode. The novel model of hidden Markov fading channels (HMFCs) is shown to be more general yet practical than the existing fading channel models. Based on a linear sliding surface, a switching-type SMC law is dedicatedly constructed by just using the estimated network mode. By exploiting the concept of stochastic Lyapunov stability and the approach of hidden Markov models, sufficient conditions are obtained for the resultant SMC systems that ensure both the mean-square stability and the reachability with a sliding region. With the aid of the Hadamard product, a binary genetic algorithm (GA) is developed to solve the proposed SMC design problem subject to some nonconvex constraints induced by the state saturations and the fading channels, where the proposed GA is based on the objective function for optimal reachability. Finally, a numerical example is employed to verify the proposed GA-assisted SMC scheme over the HMFCs.

Sub-THz spectroscopic characterization identification for pine wood nematode ribosomal DNA.

This paper, we introduced Sub-terahertz (Sub-THz) technology to identify nematode DNA sequence. First, data mining technology and restriction enzyme digestion were used to cut out two corresponding sequences, each containing about 100 base pairs that could represent the characteristic fragments of Bursaphelenchus xylophilus (Bx) and Bursaphelenchus mucronatus (Bm) rDNA in internal transcribed spacer 1 (ITS1) region. Then, vibration spectra of the two enzyme-cut sequences were measured by Fourier transform infrared spectroscopy (FTIR). Meanwhile, the spectrum was analyzed by molecular dynamics method. It was found that the calculated and experimental spectra of the two enzyme-cut sequences were consistent, although the differences of the sequences could not be well reflected in the spectra. The vibration modes corresponding to diverse absorption peaks in the spectra were quite different, which were closely related to the internal bases sequencing. This can be used as an indicator for identifying Bx and Bm DNA. Moreover, the normal mode analysis (NMA) method was first adopted for spectral attribution analysis of DNA long sequences. Finally, the vibration spectra of shorter sequences predicted by second-order Markov chains and Monte Carlo method were studied. To some extent, the predicted short sequences can represent the complete sequence as the initial calculation structure.

A simple and effective method to discern the true commercial Chinese cordyceps from counterfeits.

The Chinese cordyceps, a complex of the fungus Ophiocordyceps sinensis and its species-specific host insects, is also called "DongChongXiaCao" in Chinese. Habitat degradation in recent decades and excessive harvesting by humans has intensified its scarcity and increased the prices of natural populations. Some counterfeits are traded as natural Chinese cordyceps for profit, causing confusion in the marketplace. To promote the safe use of Chinese cordyceps and related products, a duplex PCR method for specifically identifying raw Chinese cordyceps and its primary products was successfully established. Chinese cordyceps could be precisely identified by detecting an internal transcribed spacer amplicon from O. sinensis and a cytochrome oxidase c subunit 1 amplicon from the host species, at a limit of detection as low as 32 pg. Eleven commercial samples were purchased and successfully tested to further verify that the developed duplex PCR method could be reliably used to identify Chinese cordyceps. It provides a new simple way to discern true commercial Chinese cordyceps from counterfeits in the marketplace. This is an important step toward achieving an authentication method for this Chinese medicine. The methodology and the developmental strategy can be used to authenticate other traditional Chinese medicinal materials.

Home vs hospital narrowband UVB treatment by a hand-held unit for new-onset vitiligo: A pilot randomized controlled study.

PURPOSE: To compare the efficacy and safety of narrowband ultraviolet B (NB-UVB) phototherapy in home vs in hospital for the management of limited new-onset vitiligo. METHODS: Patients with new-onset vitiligo (<3 months) with <5% body surface area involvement were recruited and randomly assigned to either a home-based or a hospital-based treatment group. Both groups were administered NB-UVB phototherapy thrice a week. The body surface area (BSA) involved with vitiligo, Vitiligo Area Scoring Index (VASI), the effectiveness of repigmentation, Vitiligo Quality of Life index (VitiQoL), and the cost of treatment were examined. RESULTS: A total of 100 patients completed the study. Patients in both groups exhibited improvements demonstrated by BSA and VSAI decrease. No significant differences were found between the two groups in terms of skin repigmentation (P > 0.05). Improvements in the VitiQoL scores were reduced to the greatest degree at week 8 for all patients in both groups. Adverse events, such as painful erythema, burning, blistering, and excessive hyperpigmentation, were more frequently observed in the home-based treatment group than in the hospital-based treatment group. The cost of phototherapy in hospital exceeded the cost of home phototherapy after 7 weeks of treatment. CONCLUSIONS: Home NB-UVB phototherapy treatment was as effective as treatment in hospital, but exhibited cost-effective and a better compliance. However, the education of the patients should be strengthened to avoid excessive UVB exposure and related adverse events.

Security and Radical Assessment in Open, Laparoscopic, Robotic Colorectal Cancer Surgery: A Comparative Study.

PURPOSE: This retrospective study was designed to assess the safety and effectiveness of open, laparoscopic, robotic colorectal cancer surgery. METHODS: Three hundred patients with colorectal cancer who underwent curative resection in the First Affiliated Hospital of Zhengzhou University between February 2014 and May 2016 were included. Patients were classified into open surgery group, laparoscopic surgery group, and robot-assisted group. RESULTS: The blood loss in laparoscopic surgery group was less than that in open surgery group, and the blood loss in robot-assisted group less was than the open surgery group. The number of lymph node dissection in robot-assisted group was significantly larger than that in the open group ( P < .05). The distance between the lower edge of the tumor group and the distal margin in robotic group was longer than that of the laparoscopic surgery group and the open group ( P < .05). Three (2.8%) cases of urinary retention occurred in the open surgery group, 4 (3.92%) cases in the laparoscopic surgery group, and 1 (1.1%) case in the robot-assisted group, while 2 (1.87%) cases of sexual dysfunction occurred in the open surgery group, 2 (1.96%) cases in the laparoscopic surgery group, and 1 (1.1%) case in the robot-assisted group. The urinary retention and sexual dysfunction rate did not differ between the 3 groups ( P > .05), but the minimally invasive group showed a certain advantage over the open group. CONCLUSION: Compared to the traditional open surgery, minimally invasive surgery (especially in robot-assisted group) has advantages such as less intraoperative bleeding, rapid postoperative recovery, and radical cure; open group, laparoscopic surgery group, and robot-assisted group have a similar incidence of postoperative complications, but reduction in the incidence of anastomotic leakage and intestinal obstruction. Robot-assisted group has the potential advantage for pelvic autonomic nerve protection.

Drinking Behavior and Associated Factors among Middle School Students in Shanghai, China.

The purpose of our study was to assess drinking status in middle school students and to understand the associated factors. The adjusted drinking rates were 50.9%, 39.8%, and 15.1% for lifetime, past-year, and current drinking, respectively. Multivariable logistic regression revealed the following variables positively related to drinking during the past year: family income, maternal educational level, family members who drink, parents who support drinking, best friends who drink, friends who encourage drinking, frequently attending friends' parties, smoking, and actuation trend (P<0.05). The main risk factors were friends (OR=6.77, 95% CI: 6.17, 7.43) and smoking (OR=4.70, 95% CI: 3.44, 6.43). These results contribute to obtaining the potential associated factors and aid in targeted intervention into the drinking behavior of middle school students.

Digital diffraction analysis enables low-cost molecular diagnostics on a smartphone.

The widespread distribution of smartphones, with their integrated sensors and communication capabilities, makes them an ideal platform for point-of-care (POC) diagnosis, especially in resource-limited settings. Molecular diagnostics, however, have been difficult to implement in smartphones. We herein report a diffraction-based approach that enables molecular and cellular diagnostics. The D3 (digital diffraction diagnosis) system uses microbeads to generate unique diffraction patterns which can be acquired by smartphones and processed by a remote server. We applied the D3 platform to screen for precancerous or cancerous cells in cervical specimens and to detect human papillomavirus (HPV) DNA. The D3 assay generated readouts within 45 min and showed excellent agreement with gold-standard pathology or HPV testing, respectively. This approach could have favorable global health applications where medical access is limited or when pathology bottlenecks challenge prompt diagnostic readouts.

Preliminary Development and Evaluation of an Algorithm to Identify Breast Cancer Chemotherapy Toxicities Using Electronic Medical Records and Administrative Data.

PURPOSE: Breast cancer chemotherapy toxicity is not well documented outside of randomized trials. We developed and conducted preliminary evaluation of an algorithm to detect grade 3 and 4 toxicities using electronic data from a large integrated managed care organization. METHODS: The algorithm used administrative, pharmacy, and electronic data from outpatient, emergency room, and inpatient records of 99 women diagnosed with breast cancer from 2006 to 2009 who underwent chemotherapy. Data were abstracted for 12 months post-treatment initiation (24 months for trastuzumab recipients). An oncology nurse independently blindly reviewed records; these results were the "gold standard." Sensitivity and specificity were calculated for overall toxicity, categories of toxicities, and toxicity by age or regimen. The algorithm was applied to an independent sample of 1,575 patients with breast cancer diagnosed during the study period to estimate prevalence rates. RESULTS: The overall sensitivity for detecting chemotherapy-related toxicity was 89% (95% CI, 77% to 95%). The highest sensitivity was for identification of hematologic toxicities (97%; 95% CI, 84% to 99%). There were good sensitivities for infectious toxicity, but rates dropped for GI and neurological toxicities. Specificity was high within each category (89% to 99%), but when combined to measure any toxicity, it was lower (70%; 95% CI, 57% to 81%). When applied to an independent chemotherapy sample, the algorithm estimates a 26% rate of hematologic toxicity; rates were higher among patients age ≥ 65 years versus less than 65 years. CONCLUSIONS: If validated in other samples and health care settings, algorithms to capture toxicity could be useful in comparative and cost-effectiveness evaluations of community practice-delivered treatment.

Observer variability in gastric neoplasm assessment using the vessel plus surface classification for magnifying endoscopy with narrow band imaging.

BACKGROUND/AIMS: Recent studies have demonstrated that magnifying endoscopy with narrow band imaging (ME-NBI) facilitates differentiation of early gastric cancer from gastric adenoma using vessel plus surface (VS) classification. This study estimated the interobserver and intraobserver agreement of endoscopists using the Yao VS classification system for the gastric mucosal surface. METHODS: We retrospectively reviewed patients who underwent endoscopic submucosal dissection or endoscopic mucosal resection, and selected cases in which preoperative ME-NBI was conducted. Before testing endoscopists, a 20-minute training module was given. Static ME-NBI images (n=47 cases) were presented to seven endoscopists (two experts and five trainees) who were asked to assess the images in 20 seconds using the Yao VS classification system. After 2 weeks, the endoscopists were asked to analyze the images again. The κ statistic was calculated for intraobserver and interobserver variability. RESULTS: The mean κ for intraobserver agreement was 0.69 (experts, 0.74; trainees, 0.64). The mean κ for interobserver agreement was 0.42 (experts, 0.49; trainees, 0.40). CONCLUSIONS: We obtained reliable results as assessed by observer variability, with only brief training on VS classification. The VS classification appears to provide an objective assessment of ME-NBI for trainees who are not familiar with ME-NBI.

Categorical spectral analysis of periodicity in human and viral genomes.

Periodicity in nucleotide sequences arises from regular repeating patterns which may reflect important structure and function. Although a three-base periodicity in coding regions has been known for some time and has provided the basis for powerful gene prediction algorithms, its origins are still not fully understood. Here, we show that, contrary to common belief, amino acid (AA) bias and codon usage bias are insufficient to create base-3 periodicity. This article applies the rigorous method of spectral envelope to systematically characterize the contributions of codon bias, AA bias and protein structural motifs to the three-base periodicity of coding sequences. The method is also used to classify CpG islands in the human genome. In addition, we show how spectral envelope can be used to trace the evolution of viral genomes and monitor global sequence changes without having to align to previously known genomes. This approach also detects reassortment events, such as those that led to the 2009 pandemic H1N1 virus.

Iodine nutrition and the prevalence of thyroid disease after salt iodization: a cross-sectional survey in Shanghai, a coastal area in China.

BACKGROUND: Both insufficient and excess iodine may produce thyroid disease. After salt iodization in China, the median urine iodine concentration (UIC) of children aged 8-10 years appeared adequate. However, it is unknown whether dietary changes due to rapid economic development in Shanghai have affected whole population iodine nutrition. OBJECTIVE: To assess dietary iodine intake, UIC and the prevalence of thyroid disease in the general population of Shanghai. DESIGN: A cross-sectional survey was conducted with general participants aged 5-69 years (n = 7,904) plus pregnant and lactating women (n = 380 each) selected by stratified multistage sampling. The iodine concentrations in their salt, drinking water and urine were measured. Daily iodine intake was estimated using the total diet study approach. Serum thyroid hormone concentrations and thyroid-related antibodies were measured and thyroid ultrasonography was performed. RESULTS: The median iodine concentration in salt was 29.5 mg/kg, and 12.8 µg/L in drinking water. Iodized salt, used by 95.3% of participants, contributed 63.5% of total dietary iodine. Estimated daily iodine intake was 225.96 µg. The median UIC of general participants was 146.7 µg/L; UIC <100 µg/L (iodine insufficiency) was seen in 28.6%; UIC >300 µg/L (iodine excess) in 10.1%. Pregnant women had a median UIC of 135.9 µg/L, with UIC <150 µg/L in 55.4%. Thyroid nodules and subclinical hypothyroidism were found in 27.44% and 9.17%, respectively. CONCLUSIONS: According to published criteria, the current dietary iodine intake in Shanghai was generally sufficient and safe, but insufficient in pregnant women. Thyroid nodules and subclinical hypothyroidism were the commonest thyroid diseases identified.

Continuous peritransplant assessment of consciousness using bispectral index monitoring for patients with fulminant hepatic failure undergoing urgent liver transplantation.

BACKGROUND: Rapid deterioration of consciousness is a critical situation for patients with fulminant hepatic failure (FHF). Bispectral (BIS) index was derived from electroencephalography parameters, primarily to monitor the depth of unconsciousness. AIM: To assess the usability of peritransplant BIS monitoring in patients with FHF. METHODS: A prospective study using peritransplant BIS monitoring was performed in 26 patients with FHF undergoing urgent liver transplantation (LT). RESULTS: Pre-transplant Child-Pugh score was 12.2 +/- 1.0; model for end-stage liver disease score was 32.4 +/- 4.4; Glasgow coma score (GCS) was 9.9 +/- 1.3; and BIS index was 44.0 +/- 6.7. Pre-transplant sedation significantly decreased BIS index. After LT, all patients having endotracheal intubation recovered consciousness within one to three d and showed progressive increase in BIS index, which appeared slightly earlier and was more evident than the increase in derived GCS score. There was a significant correlation between BIS index and derived GCS scores (r(2) = 0.648). Timing of eye opening to voice was matched with BIS index of 66.3 +/- 10.4 and occurred 12.7 +/- 8.3 h after passing BIS index of 50. CONCLUSION: These results suggest that BIS monitoring is a non-invasive, simple, easy-to-interpret method, which is useful in assessing peritransplant state of consciousness. BIS monitoring may therefore be a useful tool during peritransplant intensive care for patients with FHF showing hepatic encephalopathy.