A composite score based on cardiovascular parameters can predict the mortality risk of patients with newly diagnosed interstitial lung disease: A prospective observational study.

BACKGROUND: It is crucial to identify factors that can predict the risk of mortality in patients newly diagnosed with interstitial lung disease (ILD). This study sought to develop and assess a composite scoring system for mortality prediction among ILD patients based on cardiovascular parameters, which were previously reported as predictors of survival. METHODS: We prospectively enrolled patients with newly diagnosed ILD and monitored their survival status for 24 months. Surviving and deceased patients were compared regarding their baseline characteristics including clinical, pulmonary, and cardiovascular parameters. A system of composite scores was established based on significant cardiovascular parameters and the Gender-Age-Physiology (GAP) score. Receiver operating characteristic curves were generated to identify their optimal cut-off values. Univariate as well as multiple multivariate regression models were built to investigate the mortality prediction of different individual and combined parameters. RESULTS: Ninety-six patients newly diagnosed with ILD underwent cardiovascular evaluation. In univariate analysis, three cardiovascular parameters were identified as significant predictors of mortality risk in ILD patients, either individually or as a combination of composite scores: tricuspid regurgitation velocity > 3.1 m/s; N-terminal pro-B-type natriuretic peptide level > 300 pg/ml and computed tomography pulmonary artery/ascending aorta diameter ratio > 0.9. In multivariate analysis, a composite score of those parameters [hazard ratio (HR) = 2.37 (confidence interval [CI]:1.06-5.33); p = 0.037; Score 1] and GAP score [HR = 1.62 (CI: 1.11-2.36); p = 0.012] were the most significant predictors for mortality among ILD patients. Combination of Score 1 and GAP score (Score 2) can increase the accuracy of survival predictions (area under the curve 0.83; p < 0.001). CONCLUSIONS: A composite score based on cardiovascular parameters and the GAP score can be used to predict the risk of mortality of patients with ILD. Such a score achieved better diagnostic accuracy than the GAP score alone. Nevertheless, further larger-scale randomized controlled trials are required for evaluation of the newly proposed score and confirmation of our results.

An automated ICU agitation monitoring system for video streaming using deep learning classification.

OBJECTIVE: To address the challenge of assessing sedation status in critically ill patients in the intensive care unit (ICU), we aimed to develop a non-contact automatic classifier of agitation using artificial intelligence and deep learning. METHODS: We collected the video recordings of ICU patients and cut them into 30-second (30-s) and 2-second (2-s) segments. All of the segments were annotated with the status of agitation as "Attention" and "Non-attention". After transforming the video segments into movement quantification, we constructed the models of agitation classifiers with Threshold, Random Forest, and LSTM and evaluated their performances. RESULTS: The video recording segmentation yielded 427 30-s and 6405 2-s segments from 61 patients for model construction. The LSTM model achieved remarkable accuracy (ACC 0.92, AUC 0.91), outperforming other methods. CONCLUSION: Our study proposes an advanced monitoring system combining LSTM and image processing to ensure mild patient sedation in ICU care. LSTM proves to be the optimal choice for accurate monitoring. Future efforts should prioritize expanding data collection and enhancing system integration for practical application.

Advancing carbohydrate quantification in MALDI mass spectrometry by the rapidly freeze-drying droplet (RFDD) method.

Quantitative carbohydrate analysis faces challenges in matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS), including insufficient sensitivity and inconsistent spatial distribution of ion intensity. This study introduces an innovative sample preparation approach, the Rapidly Freeze-Drying Droplet (RFDD) method, aimed at overcoming these challenges by enhancing the homogeneity of the sample morphology and signal intensity in MALDI. Compared to conventional preparation methods, the RFDD method reduces the laser energy threshold and demonstrates a remarkable increase in signal intensity for carbohydrates, facilitating the detection of high-molecular-weight polysaccharides (>10 kDa). The RFDD-prepared samples exhibit a uniformly distributed signal intensity that overcomes the 'sweet spot' issue in MALDI. The enhanced signal intensity and reproducibility lead to reliable quantitative analysis of carbohydrates, eliminating the need for expensive isotopic standards in each sample. A straightforward and accessible approach is presented for general laboratories, revolutionizing carbohydrate analysis in MALDI-MS.

Multidisciplinary-derived clinical score for accurate prediction of long-term mortality in fibrotic lung disease patients.

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) stands out as one of the most aggressive forms of interstitial lung diseases (ILDs), currently without a definitive cure. Multidisciplinary discussion (MDD) is now considered a cornerstone in diagnosing and differentiating ILD subtypes. The Gender-Age-Physiology (GAP) score, developed to assess IPF prognosis based on sex, age, forced vital capacity, and diffusion capacity for carbon monoxide (DLCO), is limited in not considering dyspnea and functional impairment during the walking test. We proposed a MDD-based clinical score for mortality prediction among those patients. METHODS: From December 2018 to December 2019, we enrolled ILD patients with IPF and non-IPF and followed-up them till December 2020. Based on DLCO, modified Medical Research Council (mMRC) Dyspnea Scale, and six-minute walking test (6MWT) distance, a functional score was developed for mortality prediction. RESULTS: We enrolled 104 ILD patients, 12 (11.5%) died by the one-year follow-up. In receiver operating characteristic (ROC) curve analysis, DLCO (% predicted) was the most accurate variable predicting one-year mortality with an area under curve (AUC) of 0.88 (95% confidence interval [CI] = 0.80-0.94), followed by mMRC Dyspnea Score (AUC = 0.82 [95% CI = 0.73-0.89]), 6MWT distance (AUC = 0.80 [95% CI = 0.71-0.88]), and GAP score (AUC = 0.77 [95% CI = 0.67-0.84]). Only the GAP score (hazard ratio [HR] = 1.55, 95% CI = 1.03-2.34, p = 0.0.37) and functional score (HR = 3.45, 95% CI = 1.11-10.73, p = 0.032) were significantly associated with one-year mortality in multivariable analysis. CONCLUSION: The clinical score composite of DLCO, mMRC Dyspnea Scale, and 6MWT distance could provide an accurate prediction for long-term mortality in ILD patients, laying out a helpful tool for managing and following these patients.

Factors influencing long-term outcomes in fibrotic interstitial lung disease (F-ILD) diagnosed through multidisciplinary discussion (MDD): a prospective cohort study.

BACKGROUND: The diagnostic process for fibrotic interstitial lung disease (F-ILD) is notably intricate, necessitating a multidisciplinary discussion to achieve consensus based on both clinical and radiological features. This study investigated the shared and distinctive long-term mortality predictors among the two primary phenotypes of F-ILD, namely idiopathic pulmonary fibrosis (IPF) and connective tissue disease-associated interstitial lung disease (CTD-ILD). METHODS: We included patients with F-ILD diagnosed from December 2018 to December 2019 and conducted follow-up assessments until February 2023. Age, gender, usual interstitial pneumonia (UIP) pattern, gender-age-physiology (GAP) score, modified Medical Research Council (mMRC) dyspnea score, antifibrotic agent use, pulmonary function test parameters, and six-minute walking test (6MWT) parameters were recorded at baseline and used as mortality predictors in a multivariate Cox regression model. RESULTS: We enrolled 104 ILD patients. The survival rate of non-IPF patients was more than twice that of IPF patients (78.9% vs. 34%, p < 0.001), and the survival rate of patients with a GAP score of 0-2 was more than twice that of patients with a score of > 2 (93.2% vs. 36.6%, p < 0.001). Older age, male gender, definite UIP pattern, higher GAP score, higher mMRC dyspnea score, lower forced expiratory volume in one second/forced vital capacity (FEV1/FVC), shorter 6MWT distance, and lower initial and final SpO2 were also associated with higher long-term mortality (p < 0.05). In multivariable analysis, only a GAP score of > 2 (hazard ratio [HR]:16.7; 95% confidence interval [CI] 3.28-85.14; p = 0.001) and definite UIP pattern (HR: 4.08; 95% CI 1.07-15.5; p = 0.039) were significantly associated with overall mortality. CONCLUSION: The long-term mortality rate of IPF patients was higher than that of CTD-ILD patients. The GAP score and UIP patterns were significant mortality predictors for both IPF and CTD-ILD patients.

Treatment strategy for heart failure complicated with complete left bundle branch block and atrial tachycardia: a case report.

BACKGROUND: For patients with heart failure combined with complete left bundle branch block, cardiac resynchronization therapy is an important therapeutic method. If these patients also have atrial tachycardia, how to choose a treatment strategy deserves discussion. CASE PRESENTATION: A Chinese woman in her early 70s was admitted due to recurrent episodes of chest distress and asthma for 1 year. Physical and laboratory examinations showed filling of the jugular vein, lung rales, left enlargement of the heart boundary, edema of the lower limbs and elevation of N-terminal pro b-type natriuretic peptide. An electrocardiogram showed atrial tachycardia and a left bundle branch block. An echocardiography revealed enlargement of the left ventricle and left ventricular systolic dysfunction. After obtaining informed consent, the treatment strategy decided upon by the team was to use biventricular cardiac resynchronization therapy treatment and to not intervene for the atrial tachycardia, with left bundle branch area pacing as a backup. Due to twisted and narrow coronary vein branches, traditional biventricular pacing failed, and then, left bundle branch area pacing was attempted successfully. A follow-up echocardiography at 1 year showed improved systolic function. The outcomes for this patient are favorable, but the choice of interventional strategy is worthy of discussion in this case. CONCLUSION: For patients with heart failure combined with left bundle branch block and atrial tachycardia, left bundle branch area pacing can replace traditional biventricular pacing for cardiac resynchronization therapy treatment, and the therapeutic effect is significant. However, multiple factors need to be considered when formulating strategies, including whether there is bundle branch block under sinus rhythm, the success and recurrence rate of atrial tachycardia ablation, the response of cardiac resynchronization therapy, the costs of different strategies, and instrument implantation issues.

Experimental Investigation on Laser-Induced Electrochemical Silver Plating Technology.

The silver coating is widely used in electronic device manufacturing due to its excellent conductivity and soldering properties. Conventional preparation of local silver coating often uses the preplated silver, mask high-speed silver plating, and deplated silver processes. In this paper, the laser-induced electrodeposition technique is used to perform maskless laser-induced localized electrodeposition on a copper substrate preplated with a layer of silver. After the deplated silver process, ultrathin silver coatings with high dimensional accuracy, good corrosion resistance, and good bonding were obtained. The spatial distribution of the transient temperature field under laser irradiation is studied, the variation pattern of cathode substrate current under laser irradiation is tested, and finally, the spatial distribution of the pressure field under laser irradiation is simulated by Comsol. The effect of different laser scanning methods on the coating morphology was investigated, and the experimental study of the different single pulse energy-induced localized silver coatings was systematically carried out. The results show that the localized coating obtained by cross-line scanning with a laser single pulse energy of 93 µJ is flat with a film thickness of 0.23 µm, high dimensional accuracy, and good bonding force and corrosion resistance properties. This method provides a new approach for the preparation of a localized silver coating.

Analysis of competitive manufacturers' collection decisions given cross-shareholding and capital constraints.

Entrusting a third party and implementing a trade-in program are two main ways for manufacturers to collect used products. By establishing two closed-loop supply chain competition models, this study analyses the co-existence conditions of third-party collection and trade-in collection adopted by competitive manufacturers M1 and M2 respectively. Then, based on an analysis of the impact of R&D improvement on the collection decision, the impacts of horizontal cross-shareholding and financing parameters on the collection decision and profit are explored, respectively. The results show that when consumers are low-value customers who prefer cash back over purchasing a new product, competitive manufacturers with different collection channels consider improving their R&D level. The R&D improvement of M1 reduces the trade-in price and the third-party collection price, and shrinks the collection market. However, the R&D improvement of M2 increases the trade-in price and the third-party collection price. In addition, the trade-in collection market shrinks and the third-party collection market increases. In the case of cross-shareholding, the increase of M1's share helps reduce the trade-in price and the third-party collection price, while the increase of M2's share helps increase the trade-in price and the third-party collection price. In factoring financing, the increase in the factoring rate reduces the total collection quantity in the collection market, but helps improve the earnings of M2 from the collection of used products. In the case of equity financing, the increase in equity not only increases the total amount of collection, but also the earning of M1 from the collection of used products.

Unravelling intrinsic descriptors based on a two-stage activity regulation of bimetallic 2D c-MOFs for CO2RR.

The bimetallic 2D conductive MOFs of M1Pc-M2-O, possessing dual metal sites to realize flexible molecular-level structural modification, are brilliant catalysts for electrochemical CO2 reduction. However, the bimetallic centers bring about the complex regulatory mechanism of catalytic activity and obscure principles for catalyst design. Herein, systematical theoretical investigation unravels intrinsic descriptors to design favorable M1Pc-M2-O catalysts based on the discovered coarse-fine two-stage activity regulation mechanism. The reaction site controls the M-COOH distance of the key intermediate and therefore affects the reaction kinetics for the first stage of coarse regulation. The other metal site influents the d-band center of the reaction site and thus constitutes the second stage of fine regulation. The coarse and fine regulation are related to the valence electrons (V), electronegativity (E), and bond length (LM-N/O) between the metal and coordination atoms. The intrinsic descriptor ϕ = (4 × VM1 × (EM1 + EN/O)/EN/O + VM2 × (EM2 + EN/O)/EN/O) × LM1-N/O (with a coefficient ratio of 4 : 1) was eventually established and correlated well with the reported experiments. On this basis, the favorable catalysts CoPc-Zn-O and CoPc-Co-O were located. The research results could contribute to the diversity of bimetallic 2D c-MOFs in CO2RR.

Cricothyroid Dysfunction in Unilateral Vocal Fold Paralysis Females Impairs Lexical Tone Production.

In this cross-sectional study, we compared voice tone and activities relating to the laryngeal muscle between unilateral vocal fold paralysis (UVFP) patients with and without cricothyroid (CT) muscle dysfunction to define how CT dysfunction affects language tone. Eighty-eight female surgery-related UVFP patients were recruited and received acoustic voice analysis and laryngeal electromyography (LEMG) when the patient was producing the four Mandarin tones. The statistical analysis was compared between UVFP patients with (CT+ group, 17 patients) and without CT muscle (CT- group, 71 patients) involvement. When producing Mandarin Tone 2, the voice tone in the CT+ group had smaller rise range (p = 0.007), lower rise rate (p = 0.002), and lower fundamental frequency (F0) at the offset point of the voice (p = 0.023). When producing Mandarin Tone 4, the voice tone in the CT+ group had smaller drop range (p = 0.019), lower drop rate (p = 0.005), and lower F0 at voice onset (p = 0.025). The CT+ group had significantly lower CT muscle activity when producing the four Mandarin tones. In conclusion, CT dysfunction causes a limitation of high-rising tone in Tone 2 and high-falling tone in Tone 4, a property that dramatically limits the tonal characteristics in Mandarin, a tonal language. This limitation could further impair the patient's communication ability.

Intrinsic Regularity of Catalytic Cobalt Chalcogenides in Lithium-Sulfur Battery: Theoretical Study Delivers New Insights.

Cobalt chalcogenides CoX2 (X=S, Se, Te) render great performance of lithium-sulfur batteries based on catalytic capacity to alleviate shuttle effect. Given that S/Se/Te belong to the same main group, the outstanding cycling stability delivered by CoTe2 aroused the curiosity about the uniqueness of CoTe2 and intrinsic laws of cobalt chalcogenide. Herein, comprehensive theoretical study delivers new insights into the intrinsic laws of CoX2 : the relative vertical distance of two X atomic layers (rather than atom electronegativity) mainly controls adsorption; CoX2 mainly regulates the charging process (rather than discharging process) thus contributes to great cycling stability. On this basis, the advantages of CoTe2 are three-fold: moderate polysulfide adsorption, facile ion transport capacity, and surprisingly great promotion of charging process. It is hope the results will facilitate the development of cobalt chalcogenides, especially tellurides as catalytic material in lithium sulfur batteries.

Surgical Treatment for Empyema Thoracis: Prognostic Role of Preoperative Transthoracic Echocardiography and Serum Calcium.

BACKGROUND: Empyema is a major cause of mortality and hospitalization. Symptoms include difficulty breathing and chest pain. Calcium plays an essential role in the physiology of the cardiovascular system. However, there is little evidence on the role of echocardiography and the serum calcium levels of patients undergoing video-assisted thoracoscopic surgery (VATS) for empyema. This study aimed to investigate the risk factors for postoperative mortality in patients with empyema who required surgery. METHODS: This single-institution retrospective study compared the outcomes of VATS for thoracic empyema (in terms of survival and mortality) in 122 patients enrolled between July 2015 and June 2019. RESULTS: This study examined patients with thoracic empyema. The majority of the patients were males (100/122, 81.9%). The in-hospital/30-day mortality rate was 10.6% (13 patients). The calcium levels were 7.82 ± 1.17 mg/dL in the survival group and 6.88 ± 1.88 mg/dL in the mortality group (p = 0.032). In the mortality group, the utilization of echocardiography and serum calcium levels independently contributed to the risk prediction more than clinical variables. Patients in our cohort exhibited elevated pulmonary artery systolic pressure (PASP) and hypocalcemia, which were associated with increased postoperative mortality. CONCLUSION: Elevated PASP and calcium levels at the low end of the normal range demonstrated significant prognostic value in predicting mortality in patients with thoracic empyema who required surgical intervention. Recognizing this potential is critical in order to obtain better outcomes.

Cryoballoon pulmonary vein isolation and left atrial appendage occlusion prior to atrial septal defect closure: A case report.

BACKGROUND: In patients who suffer from both atrial fibrillation (AF) and atrial septal defect (ASD), cryoballoon pulmonary vein isolation (PVI), sequential left atrial appendage (LAA) occlusion and ASD closure could be a strategy for effective prevention of stroke and right heart failure. CASE SUMMARY: A 65-year-old man was admitted to our institution due to recurrent episodes of palpitations and shortness of breath for 2 years, which had been worsening over the last 48 h. He had a history of AF, ASD, coronary heart disease with stent implantation and diabetes. Physical and laboratory examinations showed no abnormalities. The score of CHA2DS2VASc was 3, and HAS-BLED was 1. Echocardiography revealed a 25-mm secundum ASD. Pulmonary vein (PV) and LAA anatomy were assessed by cardiac computed tomography. PV mapping with 10-pole Lasso catheter was performed following ablation of all four PVs with complete PVI. Following the cryoballoon PVI, the patient underwent LAA occlusion under transesophageal echocardiographic monitoring. Lastly, a 34-mm JIYI ASD occlude device was implanted. A follow-up transesophageal echocardiography at 3 mo showed proper position of both devices and neither thrombi nor leakage was found. CONCLUSION: Sequential cryoballoon PVI and LAA occlusion prior to ASD closure can be performed safely in AF patients with ASD.

Fast and direct optical dispersion estimation for ultrafast laser pulse compression.

In ultrashort pulse laser applications, optical dispersion seriously affects the energy concentration in the laser pulse duration and lowers the peak power. Accordingly, this study proposes a rapid dispersion estimation mechanism to facilitate the compensation of optical dispersion using a closed-loop control system. In the proposed approach, the optical dispersion information of the laser pulse is estimated directly from a frequency-resolved optical gating trace without the need for an iterative pulse-retrieval algorithm. In particular, the group delay dispersion (GDD) is determined from frequency and delay marginals, which are related to the laser spectrum and intensity autocorrelation, respectively, using a simple lookup table approach. The accuracy of the estimated GDD results is confirmed via a comparison with the spectral phase distribution of the electric field reconstructed using the principal component generalized projections algorithm. It is shown that the computation time of the proposed direct estimation method is around 13 times faster than that of the traditional iterative algorithm. It thus provides a feasible approach for enabling the real-time compensation of ultrafast laser pulse compression. Moreover, in a multiphoton-excited fluorescence imaging application, the proposed pulse compression mechanism yields an effective improvement in the intensity and contrast of the reconstructed image due to the increased nonlinear optical excitation efficiency of the optimized laser pulses.

The association between culture positivity and long-term mortality in critically ill surgical patients.

BACKGROUND: The long-term outcome is an essential issue in critically ill patients, and the identification of early determinant is needed for risk stratification of the long-term outcome. In the present study, we investigate the association between culture positivity during admission and long-term outcome in critically ill surgical patients. METHODS: We linked the 2015-2019 critical care database at Taichung Veterans General Hospital with the nationwide death registration files in Taiwan. We described the long-term mortality and proportion of culture positivity among enrolled subjects. We used a log-rank test to estimate survival curves between patients with and without positive cultures and a multivariable Cox proportional hazards regression model to determine hazard ratio (HR) and 95% confidence interval (CI). RESULTS: A total of 6748 critically ill patients were enrolled, and 32.5% (2196/6749) of them died during the follow-up period, with the overall follow-up duration was 1.8 ± 1.4 years. We found that 31.4% (2122/6748) of critically ill patients had at least one positive culture during the index admission, and the number of patients with positive culture in the blood, respiratory tract, urinary tract, skin and soft tissue and abdomen were 417, 1702, 554, 194 and 139, respectively. We found that a positive culture from any sites was independently associated with high long-term mortality (aHR 1.579, 95% CI 1.422-1.754) after adjusting relevant covariates, including age, sex, body-mass index, comorbidities, severity score, shock, early fluid overload, receiving mechanical ventilation and the need of renal replacement therapy for critical illness. CONCLUSIONS: We linked two databases to identify that a positive culture during admission was independently correlated with increased long-term mortality in critically ill surgical patients. Our findings highlight the need for vigilance among patients with a positive culture during admission, and more studies are warranted to validate our findings and to clarify underlying mechanisms.

Improved hydrogen evolution with SnS2 quantum dot-incorporated black Si photocathode.

Black silicon (bSi), possessing appealing light-trapping properties and large specific surface area, ranks high among many other photocathode materials. However, the insufficient dynamics towards HER seriously bother black Si. Herein, a novel photoelectrode with ultrasmall size tin sulfide quantum dot (SnS2 QD) incorporated black silicon was employed. Nanosized SnS2 possesses numerous active sites for electrochemical reactions. Impressively, benefiting from SnS2 QDs, the downward band bending of the Si Fermi level at the interface of electrolyte becomes higher, which remarkably suppresses the recombination of photo-generated carriers, thereby facilitating the participation of photo-generated electrons in PEC-HER. As a result, the thus-designed SnS2/bSi reveals an exceptional PEC-HER activity with a positive onset potential of 0.235 V vs. reversible hydrogen electrode (RHE), a high photocurrent of 1.23 mA cm-2 at 0 V vs. RHE, and long-term stability. Besides, the saturated photocurrent of ∼41 mA cm-2 is achieved at about -0.51 V vs. RHE.

Adaptive optics for dynamic aberration compensation using parallel model-based controllers based on a field programmable gate array.

Adaptive optics (AO) is an effective technique for compensating the aberrations in optical systems and restoring their performance for various applications such as image formation, laser processing, and beam shaping. To reduce the controller complexity and extend the compensation capacity from static aberrations to dynamic disturbances, the present study proposes an AO system consisting of a self-built Shack-Hartmann wavefront sensor (SHWS), a deformable mirror (DM), and field programmable gate array (FPGA)-based controllers. This AO system is developed for tracking static and dynamic disturbances and tuning the controller parameters as required to achieve rapid compensation of the incoming wavefront. In the proposed system, the FPGA estimates the coefficients of the eight Zernike modes based on the SHWS with CameraLink operated at 200 Hz. The estimated coefficients are then processed by eight parallel independent discrete controllers to generate the voltage vectors to drive the DM to compensate the aberrations. To have the DM model for controller design, the voltage vectors are identified offline and are optimized by closed-loop controllers. Furthermore, the controller parameters are tuned dynamically in accordance with the main frequency of the aberration as determined by a fast Fourier transform (FFT) process. The experimental results show that the AO system provides a low complexity and effective means of compensating both static aberrations and dynamic disturbance up to 20 Hz.

Highly Efficient Photoelectrochemical Synthesis of Ammonia Using Plasmon-Enhanced Black Silicon under Ambient Conditions.

Although photoelectrochemical synthesis of NH3 is considered as an eco-friendly and sustainable process under ambient conditions, stable and highly efficient catalysts for the N2 reduction reaction are still lacking because of the chemically inert nature of the triple bonds in elemental nitrogen and the competitive reaction of water reduction. In this paper, a photoelectrochemical N2 reduction reaction route is proposed through combining black silicon and Ag nanoparticles using a simple deposition method. The synergetic effect of Ag nanoparticles and black Si significantly enhances the activity for the ammonia evolution reaction. The obtained Ag/bSi photocathode reaches a high Faraday efficiency of 40.6% and an NH3 yield of 2.87 µmol h-1 cm-2 at -0.2 V versus the reversible hydrogen electrode in 0.1 M Na2SO4.

New Strategy to Preserve Phosphate by Ionic Liquid Matrices in Matrix-Assisted Laser Desorption/Ionization: A Case of Adenosine Nucleotides.

Adenosine -5'-triphosphate (ATP) plays a valuable role in metabolic activity to produce adequate energy in a biosystem. A high ATP/AMP ratio has a correlation with diabetes that induces suppression of AMP-activated protein kinase (AMPK). Matrix-assisted laser desorption/ionization (MALDI)-mass spectrometry (MS) has outstanding potential in determining the ratio of several types of adenosine phosphates in a sample to rapidly understand the primary energy transfer in metabolism. Although MALDI is viewed as a soft ionization technique for MS analysis, excess photon energy might crack the phosphate bonds leading to misinterpretation of the ATP level. In this work, ionic liquid matrices (ILMs) were employed to reduce fragmentation and increase the detection efficiency during the MALDI process. This study demonstrated for the first time that 2,5-dihydroxybenzoic acid pyridine (DHBP) is one of the most effective matrices for further quantitative analysis of adenosine nucleotides. This systematic screening of ILMs also enhances the fundamental understanding of MALDI.