Mean nocturnal baseline impedance in gastro-esophageal reflux disease diagnosis: Should we strictly follow the Lyon 2 Consensus?

Clinical practice guidelines drive clinical practice and clinicians rely to them when trying to answer their most common questions. One of the most important position papers in the field of gastro-esophageal reflux disease (GERD) is the one produced by the Lyon Consensus. Recently an updated second version has been released. Mean nocturnal baseline impedance (MNBI) was proposed by the first Consensus to act as supportive evidence for GERD diagnosis. Originally a cut-off of 2292 Ohms was proposed, a value revised in the second edition. The updated Consensus recommended that an MNBI < 1500 Ohms strongly suggests GERD while a value > 2500 Ohms can be used to refute GERD. The proposed cut-offs move in the correct direction by diminishing the original cut-off, nevertheless they arise from a study of normal subjects where cut-offs were provided by measuring the mean value ± 2SD and not in symptomatic patients. However, data exist that even symptomatic patients with inconclusive disease or reflux hypersensitivity (RH) show lower MNBI values in comparison to normal subjects or patients with functional heartburn (FH). Moreover, according to the data, MNBI, even among symptomatic patients, is affected by age and body mass index. Also, various studies have proposed different cut-offs by using receiver operating characteristic curve analysis even lower than the one proposed. Finally, no information is given for patients submitted to on-proton pump inhibitors pH-impedance studies even if new and extremely important data now exist. Therefore, even if MNBI is an extremely important tool when trying to approach patients with reflux symptoms and could distinguish conclusive GERD from RH or FH, its values should be interpreted with caution.

Establishment and analysis of online energy baseline for water purification plants: A case study in Kaohsiung city, Taiwan.

Water and energy are closely linked and are crucial for national security and economic development. Most water providers prioritise the stability of water supply and aim to reduce energy consumption under the premise of a stable supply. The average energy required to supply water in Taiwan in one of the lowest worldwide. In the Kaohsiung area, the average energy used by a water purification plant to provide 1 m3 of water is 0.32 kWh/m3, lower than the world average of 0.37 kWh/m3. However, the most energy-consuming plant (Weng Park water purification plant) uses eight times as much energy as the least energy-consuming plant (Pingding water purification plant). Most studies focus on the energy required to provide 1 m3 of water. This study combined attributes of four plants, such as the amount of energy consumed, quantity of water supplied, purified, and collected, and weather data. These data were used to model energy baselines for water providers. Artificial intelligence was imported into Microsoft Azure machine learning to train the model, which was verified using another Kaohsiung plant and one overseas to establish an online energy baseline modelling system that can be applied in various water purification plants.

Incorporating body mass index into esophageal manometry metrics and mean nocturnal baseline impedance for the evaluation of gastro-esophageal reflux disease.

This study aims to enhance the effectiveness of high resolution manometry (HRM) and pH-impedance monitoring metrics in distinguishing between gastro-esophageal reflux disease (GERD) and non-GERD. A retrospective propensity score matching (PSM) study was conducted on 643 patients with GERD symptoms. PSM matched 134 GERD patients with 134 non-GERD controls. Body mass index (BMI), intra-esophageal pressure (IEP) and intra-gastric pressure (IGP) were significantly higher in the GERD group compared to the non-GERD group. BMI was correlated with IEP and IGP positively. IGP was positively correlated with esophagogastric (EGJ) pressure (EGJ-P) in participants with EGJ type 1 and 2, but not in participants with EGJ type 3. BMI was correlated with distal MNBI negatively. Logistic regression showed BMI as an independent risk factor for GERD. Receiver operating characteristic curve (ROC) and decision curve analysis (DCA) showed that BMI adjusted EGJ contractile integral (EGJ-CI) and BMI adjusted MNBI were superior to the corresponding original ones in predicting GERD susceptibility. According to the findings, BMI and IGP are the main factors contributing to the development of GERD. BMI affects IEP through the adaptive response of EGJ-P to IGP. Incorporating BMI into the calculations of EGJ-CI and MNBI can improve their ability in predicting GERD susceptibility.

First Evidence of Microplastic Ingestion by Riverine Fish From the Freshwater of Northwest Peninsular Malaysia.

In a baseline study, we investigated microplastic contamination in fish from the Pinang and Kerian Rivers in Northwest Peninsular Malaysia. In recognition of the growing concern over microplastic pollution in aquatic environments, we aimed to assess the abundance and characteristics of microplastics ingested by various fish species. Fish samples were collected from local fishermen, followed by a digestion process using 10% potassium hydroxide (KOH). Microplastics were isolated and analyzed through visual examination and attenuated total reflectance Fourier transform infrared spectroscopy. The results revealed a high prevalence of microplastics, with Johnius borneensis and Oreochromis sp. exhibiting the highest abundance, averaging 48.6 and 42.8 microplastics/g, respectively. The predominant shapes were fibers (55.6%) and fragments (25.9%), with colors primarily transparent (48.19%) and black (30.12%). Our results indicate significant contamination levels in freshwater fish, emphasizing the need for further research and effective mitigation strategies. These findings provide crucial baseline data on microplastics in Malaysian freshwater ecosystems. Environ Toxicol Chem 2024;00:1-10. © 2024 SETAC.

Effects of Online Naloxone Training for Laypersons: An Extended-Baseline Assessment.

Background: While laypersons can play a crucial role in administering naloxone in opioid overdoses, they must be recruited and trained to effectively manage overdose events as good Samaritans. This study aimed to examine the effectiveness of a technology-based intervention that recruited and trained laypersons to administer naloxone. Methods: Opioid Rapid Response System (ORRS) was an online recruitment and training intervention which capitalized on social cognitive theory and a digital media engagement model to mobilize laypersons to administer intranasal naloxone. ORRS was developed based on a randomized waitlisted controlled trial (N = 220). This secondary analysis is a within-group, extended-baseline assessment of the waitlisted group (n = 106), considering that they served as their own control prior to receiving the training. ORRS was conducted in five counties of Indiana with adults who did not self-identify as a certified first responder. Five indices were generated from 23 variables: knowledge of overdose signs, knowledge of overdose management, self-efficacy in responding, concerns about responding, and intent to respond. Paired t-test compared changes between 3 timepoints. Results: Three indices had significantly greater increases associated with training compared to extended baseline: recognizing opioid overdose signs (difference = 0.08; 95%CI = 0.02, 0.15; t = 2.48; p = 0.01); knowledge of overdose management (difference = 0.27; 95%CI = 0.18, 0.35; t = 5.99; p < 0.01); and self-efficacy in overdose management (difference = 0.68; 95%CI = 0.45, 0.91; t = 5.78; p < 0.01). Concerns related to overdose management significantly decreased as expected (difference = -1.53; 95%CI = -1.86, -1.21; t = -9.27; p < 0.01). Conclusions: ORRS provided strong support for self-efficacy, concerns, and knowledge related to overdose management, and the digital modality accelerates largescale dissemination.

Human in vivo baseline intrarenal pressure, peristaltic activity and response to ureteric stenting.

OBJECTIVES: To assess human in vivo intrarenal pressure (IRP) and peristaltic activity at baseline and after ureteric stent placement, using a narrow calibre pressure guidewire placed retrogradely in the renal pelvis. PATIENTS AND METHODS: A prospective, multi-institutional study recruiting consenting patients undergoing ureteroscopy was designed with ethical approval. Prior to ureteroscopy, the urinary bladder was emptied and the COMET™ II pressure guidewire (Boston Scientific) was advanced retrogradely via the ureteric orifice to the renal pelvis. Baseline IRPs were recorded for 1-2 min. At procedure completion, following ureteric stent insertion, IRPs were recorded for another 1-2 min. Statistical analysis of mean baseline IRP, peristaltic waveforms and frequency of peristaltic contractions was performed, thereby analysing the influence of patient variables and ureteric stenting. RESULTS: A total of 100 patients were included. Baseline mean (±SD) IRP was 16.76 (6.4) mmHg in the renal pelvis, with maximum peristaltic IRP peaks reaching a mean (SD) of 25.75 (17.9) mmHg. Peristaltic activity generally occurred in a rhythmic, coordinated fashion, with a mean (SD) interval of 5.63 (3.08) s between peaks. On univariate analysis, higher baseline IRP was observed with male sex, preoperative hydronephrosis, and preoperative ureteric stenting. On linear regression, male sex was no longer statistically significant, whilst the latter two variables remained significant (P = 0.004; P < 0.001). The mean (SD) baseline IRP in the non-hydronephrotic, unstented cohort was 14.19 (4.39) mmHg. Age, α-blockers and calcium channel blockers did not significantly influence IRP, and no measured variables influenced peristaltic activity. Immediately after ureteric stent insertion, IRP decreased (mean [SD] 15.18 [5.28] vs 16.76 [6.4] mmHg, P = 0.004), whilst peristaltic activity was maintained. CONCLUSIONS: Human in vivo mean (SD) baseline IRP is 14.19 (4.39) mmHg in normal kidneys and increases with both hydronephrosis and preoperative ureteric stenting. Mean (SD) peristaltic peak IRP values of 25.75 (17.9) mmHg are reached in the renal pelvis every 3-7 s and maintained in the early post-stent period.

Relative uteroplacental insufficiency of labor.

Relative uteroplacental insufficiency of labor (RUPI-L) is a clinical condition that refers to alterations in the fetal oxygen "demand-supply" equation caused by the onset of regular uterine activity. The term RUPI-L indicates a condition of "relative" uteroplacental insufficiency which is relative to a specific stressful circumstance, such as the onset of regular uterine activity. RUPI-L may be more prevalent in fetuses in which the ratio between the fetal oxygen supply and demand is already slightly reduced, such as in cases of subclinical placental insufficiency, post-term pregnancies, gestational diabetes, and other similar conditions. Prior to the onset of regular uterine activity, fetuses with a RUPI-L may present with normal features on the cardiotocography. However, with the onset of uterine contractions, these fetuses start to manifest abnormal fetal heart rate patterns which reflect the attempt to maintain adequate perfusion to essential central organs during episodes of transient reduction in oxygenation. If labor is allowed to continue without an appropriate intervention, progressively more frequent, and stronger uterine contractions may result in a rapid deterioration of the fetal oxygenation leading to hypoxia and acidosis. In this Commentary, we introduce the term relative uteroplacental insufficiency of labor and highlight the pathophysiology, as well as the common features observed in the fetal heart rate tracing and clinical implications.

Social Vulnerability and Compliance With World Health Organization Advice on Protective Behaviors Against COVID-19 in African and Asia Pacific Countries: Factor Analysis to Develop a Social Vulnerability Index.

BACKGROUND: COVID-19 protective behaviors are key interventions advised by the World Health Organization (WHO) to prevent COVID-19 transmission. However, achieving compliance with this advice is often challenging, particularly among socially vulnerable groups. OBJECTIVE: We developed a social vulnerability index (SVI) to predict individuals' propensity to adhere to the WHO advice on protective behaviors against COVID-19 and identify changes in social vulnerability as Omicron evolved in African countries between January 2022 and August 2022 and Asia Pacific countries between August 2021 and June 2022. METHODS: In African countries, baseline data were collected from 14 countries (n=15,375) during the first Omicron wave, and follow-up data were collected from 7 countries (n=7179) after the wave. In Asia Pacific countries, baseline data were collected from 14 countries (n=12,866) before the first Omicron wave, and follow-up data were collected from 9 countries (n=8737) after the wave. Countries' socioeconomic and health profiles were retrieved from relevant databases. To construct the SVI for each of the 4 data sets, variables associated with COVID-19 protective behaviors were included in a factor analysis using polychoric correlation with varimax rotation. Influential factors were adjusted for cardinality, summed, and min-max normalized from 0 to 1 (most to least vulnerable). Scores for compliance with the WHO advice were calculated using individuals' self-reported protective behaviors against COVID-19. Multiple linear regression analyses were used to assess the associations between the SVI and scores for compliance to WHO advice to validate the index. RESULTS: In Africa, factors contributing to social vulnerability included literacy and media use, trust in health care workers and government, and country income and infrastructure. In Asia Pacific, social vulnerability was determined by literacy, country income and infrastructure, and population density. The index was associated with compliance with the WHO advice in both time points in African countries but only during the follow-up period in Asia Pacific countries. At baseline, the index values in African countries ranged from 0.00 to 0.31 in 13 countries, with 1 country having an index value of 1.00. The index values in Asia Pacific countries ranged from 0.00 to 0.23 in 12 countries, with 2 countries having index values of 0.79 and 1.00. During the follow-up phase, the index values decreased in 6 of 7 African countries and the 2 most vulnerable Asia Pacific countries. The index values of the least vulnerable countries remained unchanged in both regions. CONCLUSIONS: In both regions, significant inequalities in social vulnerability to compliance with WHO advice were observed at baseline, and the gaps became larger after the first Omicron wave. Understanding the dimensions that influence social vulnerability to protective behaviors against COVID-19 may underpin targeted interventions to enhance compliance with WHO recommendations and mitigate the impact of future pandemics among vulnerable groups.

Study on Optimization Method for InSAR Baseline Considering Changes in Vegetation Coverage.

Time-series Interferometric Synthetic Aperture Radar (InSAR) technology, renowned for its high-precision, wide coverage, and all-weather capabilities, has become an essential tool for Earth observation. However, the quality of the interferometric baseline network significantly influences the monitoring accuracy of InSAR technology. Therefore, optimizing the interferometric baseline is crucial for enhancing InSAR's monitoring accuracy. Surface vegetation changes can disrupt the coherence between SAR images, introducing incoherent noise into interferograms and reducing InSAR's monitoring accuracy. To address this issue, we propose and validate an optimization method for the InSAR baseline that considers changes in vegetation coverage (OM-InSAR-BCCVC) in the Yuanmou dry-hot valley. Initially, based on the imaging times of SAR image pairs, we categorize all interferometric image pairs into those captured during months of high vegetation coverage and those from months of low vegetation coverage. We then remove the image pairs with coherence coefficients below the category average. Using the Small Baseline Subset InSAR (SBAS-InSAR) technique, we retrieve surface deformation information in the Yuanmou dry-hot valley. Landslide identification is subsequently verified using optical remote sensing images. The results show that significant seasonal changes in vegetation coverage in the Yuanmou dry-hot valley lead to noticeable seasonal variations in InSAR coherence, with the lowest coherence in July, August, and September, and the highest in January, February, and December. The average coherence threshold method is limited in this context, resulting in discontinuities in the interferometric baseline network. Compared with methods without baseline optimization, the interferometric map ratio improved by 17.5% overall after applying the OM-InSAR-BCCVC method, and the overall inversion error RMSE decreased by 0.5 rad. From January 2021 to May 2023, the radar line of sight (LOS) surface deformation rate in the Yuanmou dry-hot valley, obtained after atmospheric correction by GACOS, baseline optimization, and geometric distortion region masking, ranged from -73.87 mm/year to 127.35 mm/year. We identified fifteen landslides and potential landslide sites, primarily located in the northern part of the Yuanmou dry-hot valley, with maximum subsidence exceeding 100 mm at two notable points. The OM-InSAR-BCCVC method effectively reduces incoherent noise caused by vegetation coverage changes, thereby improving the monitoring accuracy of InSAR.

EEG Functional Connectivity Analysis for the Study of the Brain Maturation in the First Year of Life.

Brain networks are hypothesized to undergo significant changes over development, particularly during infancy. Thus, the aim of this study is to evaluate brain maturation in the first year of life in terms of electrophysiological (EEG) functional connectivity (FC). Whole-brain FC metrics (i.e., magnitude-squared coherence, phase lag index, and parameters derived from graph theory) were extracted, for multiple frequency bands, from baseline EEG data recorded from 146 typically developing infants at 6 (T6) and 12 (T12) months of age. Generalized linear mixed models were used to test for significant differences in the computed metrics considering time point and sex as fixed effects. Correlational analyses were performed to ascertain the potential relationship between FC and subjects' cognitive and language level, assessed with the Bayley-III scale at 24 (T24) months of age. The results obtained highlighted an increased FC, for all the analyzed frequency bands, at T12 with respect to T6. Correlational analyses yielded evidence of the relationship between FC metrics at T12 and cognition. Despite some limitations, our study represents one of the first attempts to evaluate brain network evolution during the first year of life while accounting for correspondence between functional maturation and cognitive improvement.

Baseline tebuconazole sensitivity and potential resistant risk in Fusarium Graminearum.

BACKGROUND: The Fusarium head blight caused by Fusarium graminearum results in reduced crop yields and the potential for vomitoxin contamination, which poses a risk to both human and livestock health. The primary method of control relies on the application of chemical fungicides. RESULTS: The current study found that the tebuconazole sensitivity of 165 F. graminearum isolates collected from the Huang-Huai-Hai region of China between 2019 and 2023 ranged from 0.005 to 2.029 µg/mL, with an average EC50 value of 0.33 ± 0.03 µg/mL. The frequency distribution conformed to a unimodal curve around the mean, and therefore provides a useful reference for monitoring the emergence of tebuconazole resistance in field populations of F. graminearum. No cross-resistance was detected between tebuconazole and other unrelated fungicides such as flutriafol, propiconazole and fluazinam, but there was a clear negative cross-resistance with triazole fungicides including fludioxonil, epoxiconazole, hexaconazole, and metconazole. Analysis of five tebuconazole-resistant mutants produced under laboratory conditions indicated that although the mycelial growth of the mutants were significantly (p < 0.05) reduced, spore production and germination rates could be significantly (p < 0.05) increased. However, pathogenicity tests confirmed a severe fitness cost associated with tebuconazole resistance, as all of the mutants completely loss the ability to infect host tissue. Furthermore, in general the resistant mutants were found to have increased sensitivity to abiotic stress, such as ionic and osmotic stress, though not to Congo red and oxidative stress, to which they were more tolerant. Meanwhile, molecular analysis identified several point mutations in the CYP51 genes of the mutants, which resulted in two substitutions (I281T, and T314A) in the predicted sequence of the FgCYP51A subunit, as well as seven (S195F, Q332V, V333L, L334G, M399T, E507G, and E267G) in the FgCYP51C subunit. In addition, it was also noted that the expression of the CYP51 genes in one of the mutants, which lacked point mutations, was significantly up-regulated in response to tebuconazole treatment. CONCLUSIONS: These results provide useful data that allow for more rational use of tebuconazole in the control of F. graminearum, as well as for more effective monitoring of fungicide resistance in the field.

Detection and Visualization of Minor Irradiation-Induced Changes in Polytetrafluoroethylene (PTFE) by Raman Spectroscopy.

Exposure of polytetrafluoroethylene (PTFE) to argon plasma results in chemical modification of the polymer near the surface. Interestingly, PTFE modification can be induced by the sub-band gap ultraviolet (UV) irradiation. In the latter case, the changes in the chemical structure are very subtle, and they are practically invisible to conventional experimental techniques. Raman spectra of irradiated and raw samples show practically identical peaks. However, the baseline that is commonly considered as an unwanted spectral component contains an important information that reflects the minor structural changes. With the proper data analysis, this allows us to visualize the effects of the argon plasma and sub-band gap UV irradiation on the polymer.

Studies on the conservation and sustainability challenges of the wetland resources of the Baro-Akobo River Basin in Gambella and Benishangul-Gumuz regions, Ethiopia.

In this study, the water quality of the Baro-Akobo River Basin in Ethiopia was comprehensively assessed. Key parameters including temperature (°C), pH, dissolved oxygen (DO), electrical conductivity, total dissolved solids (TDS), and ion concentrations such as K+, Ca2+, Na+, NO3 -, NO2 -, PO4 3-, CO3 2-, HCO3 -, and NH4 +were measured using standard methods, alongside sampling of phytoplankton, zooplankton, macroinvertebrates, macrophytes, and fish. Phytoplankton and zooplankton were sampled using Hydrobios nets with mesh sizes of 30 µm and 55 µm, respectively, while macroinvertebrates were collected via the kicking method. Results indicated generally alkaline pH levels and elevated turbidity, but acceptable levels of dissolved oxygen and ion concentrations according to WHO and FAO guidelines. Moreover, the study suggests that the wetlands in Gambella and Benishangul-Gumz regions are currently in good condition, providing valuable insights for the conservation and sustainable management of Ethiopia's water resources, ensuring their conservation for both present and future generations. Local authorities can use the study's findings to implement remedial measures to protect water quality and biodiversity in the regions.

Test-retest and interrater reliability of experimental within-subject variability of pain reports as assessed by the focused analgesia selection test.

Introduction: Within-subject variability (WSV) of pain intensity reports has been shown to predict the placebo response. The focused analgesia selection test (FAST), which allows to experimentally assess WSV of pain reports, has been used as a screening tool to identify participants who are likely to have a strong placebo response in drug-development clinical trials. Yet, the reliability of FAST has not been reported. Objectives: To assess test-retest and interrater reliability of the FAST outcomes. To mimic pharma-sponsored clinical trials, we enlisted inexperienced assessors who underwent limited training. Methods: Healthy volunteers performed the FAST twice within a week and were randomly assigned to either the test-retest group or the interrater group. T-tests, partial Pearson correlations, intraclass correlations (ICC), and Bland-Altman plots were generated to assess FAST outcomes' reliability. Results: Sixty-three participants completed the study and were assigned to the test-retest (N = 33) or interrater (N = 30) arms. No statistically significant differences in the FAST outcomes were detected between the 2 sessions, except for the FAST covariance (FAST CoV) in the interrater assessment (P = 0.009). Test-retest reliabilities of the FAST-main outcomes were r = 0.461, ICC = 0.385 for the FAST R 2 and r = 0.605, ICC = 0.539 for the FAST ICC and in the interrater cohort, they were FAST R 2: r = 0.321, ICC = 0.337 and FAST ICC: r = 0.355, ICC = 0.330. Conclusion: Using inexperienced assessors, the FAST outcomes test-retest ranged from moderate to strong, whereas the interrater reliability ranged from weak to poor. These results highlight the importance of adequately training study staff members before using this tool in multicentre clinical trials.

Predicting pre- and post-operative acute kidney injury in elderly patients with coronary artery disease.

Background: Limited evidence exists regarding the clinical baseline characteristics at admission for acute kidney injury (AKI) before and after interventional cardiac procedures (ICP) in elderly patients with coronary artery disease (CAD). Methods: A total of 488 elderly patients were enrolled in this retrospective single-center study conducted from January 2019 to July 2022, and a classification and regression tree (CART) analysis was performed to identify the high-risk population. Results: The AKI incidence was 21.1 % (103/488) in this study, with 27 and 76 individuals developing AKI before and after ICP, respectively. CART analysis revealed that exposure to nephrotoxic drugs and diuretics had the strongest predictive capacities for identifying patients at risk of developing pre-ICP AKI, with the incidence among these high-risk patients ranging from 6.5 % to 13.8 %. Meanwhile, the optimum discriminators for identifying those at high risk of post-ICP AKI were the administration of diuretics, D-value ≤ -860 mL, age >73 years, and administration of nephrotoxic drugs, and the latter model predicted that the AKI incidence among high-risk patients was between 50.0 % and 60.0 %. Conclusions: Elderly patients with CAD exhibited an elevated incidence of AKI. CART models suggested that exposure to nephrotoxic drugs and diuretics, D-value, and age were significantly associated with AKI in the elderly with CAD. Importantly, these baseline characteristics at admission could be utilized to identify elderly patients at high risk of pre- and post-ICP AKI.

Impact of Postarrest Vasoactive-Inotropic Score on Acute Kidney Injury in Cardiac Arrest Survivors: A Retrospective Cohort Study.

Background: Postarrest acute kidney injury (AKI) is a major health burden because it is associated with prolonged hospitalization, increased dialysis requirement, high mortality, and unfavorable neurological outcomes. Managing hemodynamic instability during the early postarrest period is critical; however, the role of quantified vasopressor dependence in AKI development in relation to illness severity remains unclear. Methods: A retrospective, observational cohort study that enrolled 411 non-traumatic adult cardiac arrest survivors without pre-arrest end-stage kidney disease between January 2017 and December 2019, grouped according to their baseline kidney function. The criteria for kidney injury were based on the Kidney Disease: Improving Global Outcomes definition and AKI staging system. The degree of vasopressor dependence within the first 24 h following return of spontaneous circulation (ROSC) was presented using the maximum vasoactive-inotropic score ( VIS max ). Results: Of the 411 patients, 181 (44%) had early AKI after ROSC. Patients with AKI showed an increased risk of in-hospital mortality (adjusted OR [aOR] 5.40, 95% CI 3.36-8.69, p < 0.001) and unfavorable neurological outcome (aOR 5.70, 95% CI 3.45-9.43, p < 0.001) compared to patients without AKI. The risk of adverse outcomes increased with illness severity. Patients with vasopressor support had an increased risk of early AKI. A low VIS max was associated with AKI stage 1-2 (aOR 2.51, 95% CI 1.20-5.24), whereas a high VIS max was associated with an increased risk for AKI stage 3 (aOR 2.46, 95% CI 1.28-4.75). Conclusions: Early AKI is associated with an increased risk of in-hospital mortality and unfavorable neurologic recovery in cardiac arrest survivors. Postarrest VIS max is an independent predictor of the development and severity of AKI following ROSC, regardless of baseline kidney function.

Fertilizer management practices in potato cultivation: a baseline study for the introduction of GE potato in Bangladesh.

Genetically engineered (GE) crops have the potential to contribute to agricultural sustainability, food security, and nutritional enrichment. However, these crops cannot be released for commercial cultivation without undergoing environmental risk assessments (ERA), thus biosafety evaluation. ERA assessments are performed comparatively with their natural non-GE counterparts. As Bangladesh is progressing with GE potato research, the present study aims to collect baseline information on non-GE potato cultivation with an emphasis on current agronomic practices focusing on fertilizer management and farmers' knowledge base. The survey had three parts, including information on the farmers, information on potato cultivation practices, especially fertilizer use, and lastly, the farmer's view on GE potato. From 2020 to 2021, data were collected through interviews with experienced growers in four potato-growing regions, the Central and Mid-East, North-West, Mid-West, and South-East regions (n = 1757) of the country. The study revealed that farmers of all regions used more than the recommended amounts of fertilizer; for instance, 67.1% more nitrogen fertilizer was applied as an extra dose during potato cultivation in Munshiganj (Central and Mid-East) than in the Dinajpur region (North-West). This overuse of nitrogen fertilizer can enhance plant vigor but makes the plants more susceptible to insect attraction and allows pests easier access to the plants. As a result, the excess dose of nitrogen fertilizer in Munshiganj may act as a catalyst to increase the probability of late blight. The findings also showed that 73.6% of farmers observed unexpected flowering in certain potato cultivars, which corresponded to the higher application of phosphate and potassium fertilizers aimed at late blight control. Furthermore, this study reported infestations of Solanaceous weeds, specifically Solanum torvum and Physalis heterophylla, in potato fields. Finally, our findings demonstrated that more than 68.7% of the potato growers intend to adopt disease-resistant GE potato as that may reduce the need for excess fertilizer use and thus reduce cultivation costs.

Differential symptom cluster responses and predictors to repetitive transcranial magnetic stimulation treatment in Parkinson's disease: A retrospective study.

Background: Repetitive transcranial magnetic stimulation (rTMS) is an effective noninvasive neuromodulation technique for Parkinson's disease (PD). However, the efficacy of rTMS varies widely between individuals. This study aimed to investigate the factors related to the response to rTMS in PD patients. Methods: We retrospectively analyzed the response of 70 idiopathic PD patients who underwent rTMS for 14 consecutive days targeting the supplementary motor area (SMA) in either an open-label trail (n = 31) or a randomized, double-blind, placebo-controlled trial (RCT) (n = 39). The motor symptoms of PD patients were assessed by the United Parkinson's Disease Rating Scale Part III (UPDRSIII). Based on previous studies, the UPDRSIII were divided into six symptom clusters: axial dysfunction, resting tremor, rigidity, bradykinesia affecting right and left extremities, and postural tremor. Subsequently, the efficacy of rTMS to different motor symptom clusters and clinical predictors were analyzed in these two trails. Results: After 14 days of treatment, only the total UPDRSIII scores and rigidity scores improved in both the open-label trial and the RCT. The results of multiple linear regression analysis indicated that baseline rigidity scores (ß = 0.37, p = 0.047) and RMT (ß = 0.30, P = 0.02) positively predicted the improvement of UPDRSIII. The baseline rigidity score (ß = 0.55, P < 0.0001) was identified as an independent factor to predict the improvement of rigidity. Conclusion: This study demonstrated significant improvements in total UPDRSIII scores and rigidity after 14-day treatment, with baseline rigidity scores and RMT identified as predictors of treatment response, underscoring the need for individualized therapy.

Baseline health parameters of rhinoceros auklets (Cerorhinca monocerata) using serum protein electrophoresis, acute phase proteins, and biochemistry.

Clinical metrics of baseline health in sentinel seabird species can offer insight into marine ecosystem dynamics, individual and population health, and assist in wildlife rehabilitation and conservation efforts. Protein electrophoresis is useful for detecting changes in acute phase proteins and immunoglobulin levels that may indicate subtle inflammatory responses and/or infectious disease. Serum biochemistry can highlight nutritional status, metabolic derangements, and organ injury and function. However, baseline values for such health parameters are largely unknown for many seabird species. Therefore, the objective of this study is to establish baseline clinical health reference intervals for serum protein electrophoresis, acute phase proteins including serum amyloid A and haptoglobin, and biochemistry parameters in the rhinoceros auklet (Cerorhinca monocerata), a key sentinel species in the North Pacific. From 2013 to 2019, 178 wild, apparently healthy breeding adult rhinoceros auklets were captured across four breeding colonies in British Columbia, Canada (Lucy Island, Pine Island, Triangle Islands, and SGang Gwaay) and from one colony in Washington, United States (Protection Island). Reference intervals were calculated for protein electrophoresis fractions and acute phase proteins (n = 163), and serum biochemistry (n = 35) following established guidelines by the American Society of Veterinary Clinical Pathology. Animals were also assessed for the presence of antibodies to the influenza A virus. Approximately 48% (70/147) of sampled birds were seropositive for influenza A virus, with a prevalence of 50% (6/12) in 2013, 75% (47/63) in 2014, and 24% (17/72) in 2019. This work provides clinical baseline health metrics of a key North Pacific sentinel species to help inform marine ecosystem monitoring, recovery, and rehabilitation efforts in the Pacific Northwest.