[Association of metal/metalloids exposure with abnormal liver function among occupational population in a mining area of Hunan Province:a prospective study].

OBJECTIVE: To investigate the association of metals/metalloids exposure with risk of liver disfunction among occupational population in Hunan Province, and to explore the potential dose-response relationship. METHODS: In 2017, a mining area in Hunan Province was chosen as the research site, and eligible workers were recruited as study subjects. General demographic characteristics, levels of 23 metals/metalloids in plasma and urine, and liver function index(total bilirubin(TBIL), alanine amino transferase(ALT), globulin(GLB) and γ-glutamyl transferase(GGT)) were obtained by questionnaire, physical examination and laboratory tests. Participants were followed up in 2018, 2019 and 2020 respectively. Cox proportional risk model was used to evaluate the relationship between metal/metalloids exposure and risk of liver disfunction, and dose-response relationship curves were plotted by using the restricted cubic spline function. RESULTS: A total of 891 employees were recruited in the study, 576(65.0%)were aged ≤45 years, 832(93.4%) were male and 530(59.5%) worked as smelters. After adjusting various factors such as age, gender, BMI, type of work, education, smoking, alcohol consumption, diet, stress, medical history, exercise and tea consumption, positive correlations were found between plasma tungsten(HR=4.90, 95%CI 1.17-20.48) and urinary barium(HR=1.07, 95%CI 1.02-1.12) levels with abnormally elevated TBIL levels. Additionally, a significant association was observed between plasma thallium and the risk of elevated ALT levels(HR=11.15, 95%CI 1.97-63.29). CONCLUSION: Plasma tungsten and thallium, along with barium found in urine, are risk factors for the development of abnormally elevated liver function indices in occupational groups.

[Determination of 24 elements migration in Yixing clay pottery by inductively coupled plasma mass spectrometry].

OBJECTIVE: To establish an analytical method for determining the migration of 24 elements in Yixing clay pottery in 4% acetic acid simulated solution by inductively coupled plasma mass spectrometry. METHODS: Four types of Yixing clay pottery, including Yixing clay teapot, Yixing clay kettle, Yixing clay pot, and Yixing clay electric stew pot, were immersed in 4% acetic acid as a food simulant for testing. The migration amount of 24 elements in the migration solution was determined using inductively coupled plasma mass spectrometry. RESULTS: Lithium, magnesium, aluminum, iron, and barium elements with a mass concentration of 1000 µg/L; Lead, cadmium, total arsenic, chromium, nickel, copper, vanadium, manganese, antimony, tin, zinc, cobalt, molybdenum, silver, beryllium, thallium, titanium, and strontium elements within 100 µg/L there was a linear relationship within, the r value was between 0.998 739 and 0.999 989. Total mercury at 5.0 µg/L, there was a linear relationship within, the r value of 0.995 056. The detection limit of the elements measured by this method was between 0.5 and 45.0 µg/L, the recovery rate was 80.6%-108.9%, and the relative standard deviation was 1.0%-4.8%(n=6). A total of 32 samples of four types of Yixing clay pottery sold on the market, including teapots, boiling kettles, casseroles, and electric stewing pots, were tested. It was found that the migration of 16 elements, including beryllium, titanium, chromium, nickel, cobalt, zinc, silver, cadmium, antimony, total mercury, thallium, tin, copper, total arsenic, molybdenum, and lead, were lower than the quantitative limit. The element with the highest migration volume teapot was aluminum, magnesium, and barium; The kettle was aluminum and magnesium; Casserole was aluminum, magnesium, and lithium; The electric stew pot was aluminum. CONCLUSION: This method is easy to operate and has high accuracy, providing an effective and feasible detection method for the determination and evaluation of element migration in Yixing clay pottery.

IDDSI-compliant recipes containing oral contrast agents for radiological dysphagia diagnostics.

Videofluoroscopic swallowing study (VFSS), alongside flexible endoscopic evaluation of swallowing, represents the gold standard for diagnosing swallowing disorders and to determine severity, pathophysiology, and effective interventions, including texture modification. The clinical swallowing examination and assessment supplements these instrumental methods and serves as the basis for the modules of swallowing diagnostics. The adaptation of food and drink consistencies in dysphagia management has become widespread. For valid results of a VFSS with respect to confirming swallowing safety and efficiency of different liquid and food consistencies and textures, the use of uniform recipes containing radio-opaque contrast media is important. Our goal was to identify recipes that would produce consistencies that conform to the liquid and food levels of 0-7, as defined by the International Dysphagia Diet Standardization Initiative (IDDSI), with barium- and iodine-based contrast media, xanthan gum-based thickeners, and other edible components, which also show sufficient contrast on VFSS. In this study, we determined the different recipes using IDDSI testing methods and explored their radiological characteristics using a Philips MultiDiagnost Eleva fluoroscopy system and two different fluid contrast agents: barium- (Micropaque®) and iodine-based (Telebrix®). All recipes showed sufficient contrast on fluoroscopy and could be visualized in the amounts used for swallowing examinations. They were practical and easy to implement in terms of production and availability of the components. The homogeneity of the recipes diminished with higher IDDSI levels, which represent transitional food, but appeared still sufficient for fluoroscopic examination. The opacity did not significantly differ between the barium- and iodine-based contrast media.

Mutation in pore-helix modulates interplay between filter gate and Ba2+ block in a Kcv channel pore.

The selectivity filter of K+ channels catalyzes a rapid and highly selective transport of K+ while serving as a gate. To understand the control of this filter gate, we use the pore-only K+ channel KcvNTS in which gating is exclusively determined by the activity of the filter gate. It has been previously shown that a mutation at the C-terminus of the pore-helix (S42T) increases K+ permeability and introduces distinct voltage-dependent and K+-sensitive channel closures at depolarizing voltages. Here, we report that the latter are not generated by intrinsic conformational changes of the filter gate but by a voltage-dependent block caused by nanomolar trace contaminations of Ba2+ in the KCl solution. Channel closures can be alleviated by extreme positive voltages and they can be completely abolished by the high-affinity Ba2+ chelator 18C6TA. By contrast, the same channel closures can be augmented by adding Ba2+ at submicromolar concentrations to the cytosolic buffer. These data suggest that a conservative exchange of Ser for Thr in a crucial position of the filter gate increases the affinity of the filter for Ba2+ by >200-fold at positive voltages. While Ba2+ ions apparently remain only for a short time in the filter-binding sites of the WT channel before passing the pore, they remain much longer in the mutant channel. Our findings suggest that the dwell times of permeating and blocking ions in the filter-binding sites are tightly controlled by interactions between the pore-helix and the selectivity filter.

Investigating the impact of elevated urinary trace elements on non-alcoholic fatty liver disease using vibration-controlled transient elastography.

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a global public health concern. However, limited data are available on urinary trace elements and NAFLD caused by various exposure factors. This study aimed to investigate the relationship between the presence of 16 trace elements in urine and NAFLD using data from the National Health and Nutrition Examination Survey (NHANES). Methods: By utilizing the NHANES data from 2017 to 2018, 1613 participants who fulfilled the research criteria were identified from the initial pool of 2979 participants with available urine trace element detection data. Among them, 706 individuals had been diagnosed with NAFLD based on a coefficient of attenuation parameter (CAP) value of at least 274 db/m, determined using vibration-controlled transient elastography (VCTE); whereas the remaining 907 participants were classified as non-NAFLD. The data obtained were used to construct univariate and multivariate logistic regression models and restricted cubic spline models (RCS) analyses. Results: The presence of arsenic, iodine, barium, cesium, molybdenum, lead, tin, and tungsten in the urine of individuals with NAFLD showed a positive correlation with the likelihood of developing NAFLD. The risk of NAFLD had a non-linear dose-dependent relationship with urinary iodine, molybdenum, barium, and cesium. NAFLD was also associated with elevated levels of barium and cesium in urine, which were identified as significant risk factors. Conclusion: These findings suggest a positive association between exposure to trace elements in the urine and the risk of NAFLD. Specifically, urinary barium and cesium appeared to have the greatest impact on the risk of NAFLD. These results provide novel insights into the diagnosis and treatment of NAFLD.

Structural insight and in silico prediction of the pharmacokinetic parameters and toxicity of alkaline earth metal compounds strontium and barium with the non-steroidal anti-inflammatory drug nimesulide.

In the crystals of alkaline earth metal compounds strontium and barium with the non-steroidal anti-inflammatory drug nimesulide, the strontium cation is nine-coordinated with a distorted tricapped trigonal prismatic geometry TCTPR-9, whereas the ten-coordinated barium ion exhibits a distorted tetracapped trigonal prismatic geometry TCTPR-10.

Radiation shielding assessment for interventional radiology personnel: Geant4 dosimetry of lead-free compositions.

The inherent biological hazards associated with ionizing radiation necessitate the implementation of effective shielding measures, particularly in medical applications. Interventional radiology, in particular, poses a unique challenge as it often exposes medical personnel to prolonged periods of high x-ray doses. Historically, lead and lead-based compounds have been the primary materials employed for shielding against photons. However, the drawbacks of lead, including its substantial weight causing personnel's inflexibility and its toxicity, have raised concerns regarding its long-term impact on both human health and the environment. Barium tantalate has emerged as a promising alternative, due to its unique attenuation properties against low-energy x-rays, specifically targeting the weak absorption area of lead. In the present study, we employ the Geant4 Monte Carlo simulation tool to investigate various formulations of barium tantalate doped with rare earth elements. The aim is to identify the optimal composition for shielding x-rays in the context of interventional radiology. To achieve this, we employ a reference x-ray spectrum typical of interventional radiology procedures, with energies extending up to 90 keV, within a carefully designed simulation setup. Our primary performance indicator is the reduction in air kerma transmission. Furthermore, we assess the absorbed doses to critical organs at risk within a standard human body phantom protected by the shield. Our results demonstrate that specific concentrations of the examined rare earth impurities can enhance the shielding performance of barium tantalate. To mitigate x-ray exposure in interventional radiology, our analysis reveals that the most effective shielding performance is achieved when using barium tantalate compositions containing 15% Erbium or 10% Samarium by weight. These findings suggest the possibility of developing lead-free shielding solutions or apron for interventional radiology personnel, offering a remarkable reduction in weight (exceeding 30%) while maintaining shielding performance at levels comparable to traditional lead-based materials.

l-Cysteine and barium titanate co-modified enteromorpha biochar as effective peroxymonosulfate activator for atrazine treatment.

In this study, pyrolysis and hydrothermal methods were used for Enteromorpha biochar that was co-modified with l-cysteine and barium titanate (LBCBa). It has great environmental tolerance and can remove 93.0 % of atrazine (ATZ, 10 mg·L-1) within 60 mins of ultrasonic treatment. The enhanced hydrophilicity, electron-donating capability, and piezoelectricity of LBCBa are considered to induce excellent performance. The apparent reaction rate of the LBCBa-2/PMS/ATZ system with ultrasonic was 2.87 times that without ultrasonic. The density functional theory points out that, introducing l-cysteine to carbon edges improves the adsorption of ATZ and peroxymonosulfate (PMS), making PMS easier to activate. This work offered unique insights for fabricating effective catalysts and demonstrated the combination of hydrophilic functional groups and piezoelectricity in improving catalytic performance and stability.

Joint associations among non-essential heavy metal mixtures and nutritional factors on glucose metabolism indexes in US adults: evidence from the NHANES 2011-2016.

Dietary intake can modify the impact of metals on human health, and is also closely related to glucose metabolism in human bodies. However, research on their interaction is limited. We used data based on 1738 adults aged ≥20 years from the National Health and Nutrition Examination Survey 2011-2016. We combined linear regression and restricted cubic splines with Bayesian kernel machine regression (BKMR) to identify metals associated with each glucose metabolism index (P < 0.05 and the posterior inclusion probabilities of BKMR >0.5) in eight non-essential heavy metals (barium, cadmium, antimony, tungsten, uranium, arsenic, lead, and thallium) and glucose metabolism indexes [fasting plasma glucose (FPG), blood hemoglobin A1c (HbA1c) and homeostatic model assessment of insulin resistance (HOMA-IR)]. We identified two pairs of metals associated with glucose metabolism indexes: cadmium and tungsten to HbA1c and barium and thallium to HOMA-IR. Then, the cross-validated kernel ensemble (CVEK) approach was applied to identify the specific nutrient group (nutrients) that interacted with the association. By using the CVEK model, we identified significant interactions between the energy-adjusted diet inflammatory index (E-DII) and cadmium, tungsten and barium (all P < 0.05); macro-nutrients and cadmium, tungsten and barium (all P < 0.05); minerals and cadmium, tungsten, barium and thallium (all P < 0.05); and A vitamins and thallium (P = 0.043). Furthermore, a lower E-DII, a lower intake of carbohydrates and phosphorus, and a higher consumption of magnesium seem to attenuate the positive association between metals and glucose metabolism indexes. Our finding identifying the nutrients that interact with non-essential heavy metals could provide a feasible nutritional guideline for the general population to protect against the adverse effects of non-essential heavy metals on glucose metabolism.

The interpretable machine learning model associated with metal mixtures to identify hypertension via EMR mining method.

There are limited data available regarding the connection between hypertension and heavy metal exposure. The authors intend to establish an interpretable machine learning (ML) model with high efficiency and robustness that identifies hypertension based on heavy metal exposure. Our datasets were obtained from the US National Health and Nutrition Examination Survey (NHANES, 2013-2020.3). The authors developed 5 ML models for hypertension identification by heavy metal exposure, and tested them by 10 discrimination characteristics. Further, the authors chose the optimally performing model after parameter adjustment by Genetic Algorithm (GA) for identification. Finally, in order to visualize the model's ability to make decisions, the authors used SHapley Additive exPlanation (SHAP) and Local Interpretable Model-Agnostic Explanations (LIME) algorithm to illustrate the features. The study included 19 368 participants in total. A best-performing eXtreme Gradient Boosting (XGB) with GA for hypertension identification by 16 heavy metals was selected (AUC: 0.774; 95% CI: 0.772-0.776; accuracy: 87.7%). According to SHAP values, Barium (0.02), Cadmium (0.017), Lead (0.017), Antimony (0.008), Tin (0.007), Manganese (0.006), Thallium (0.004), Tungsten (0.004) in urine, and Lead (0.048), Mercury (0.035), Selenium (0.05), Manganese (0.007) in blood positively influenced the model, while Cadmium (-0.001) in urine negatively influenced the model. Study participants' hypertension associated with heavy metal exposure was identified by an efficient, robust, and interpretable GA-XGB model with SHAP and LIME. Barium, Cadmium, Lead, Antimony, Tin, Manganese, Thallium, Tungsten in urine, and Lead, Mercury, Selenium, Manganese in blood are positively correlated with hypertension, while Cadmium in blood is negatively correlated with hypertension.

High-Performance Piezoelectric Nanogenerator of BTO-PVDF Nanofibers for Wearable Sensing.

Piezoelectric nanogenerator (PENG) produces stable electrical signals in response to external mechanical stimuli and holds promise in the fields of flexible sensors and smart wearable devices. In practice, a high-performance PENG with a straightforward structure and exceptional reliability is deeply desired. This study optimally synthesizes piezoelectric composites comprising polyvinylidene fluoride (PVDF) incorporated with barium titanate (BTO) nanoparticles (NPs) and fabricated a PENG with heightened sensitivity by using the electrospinning technique. The polar ß-phase content of the dual-optimized BTO-PVDF (barium titanate and polyvinylidene fluoride) electrospun fiber reaches up to 82.39%. In the bending mode, it achieves a remarkable maximum open-circuit voltage of 19.152 V, a transferred charge of 8.058 nC, and an output voltage per unit area of 2.128 V cm- 2. Under vertical pressure conditions, the BP-PENG exhibits an impressive voltage of 12.361 V while the force is 2.156 N, demonstrating a notable pressure sensing sensitivity of 5.159 V kPa-1, with an excellent linear relationship. Furthermore, the BP-PENG displays sensitive sensing features in monitoring hand movements. The sensitive response and high performance make it promising for applications in human motion monitoring and smart wearable devices.

3D printed barium titanate/calcium silicate composite biological scaffold combined with structural and material properties.

In the case of a large bone defect, the human endogenous electrical field is no longer sufficient. Therefore, it is necessary to support structural electrical bone scaffolds. Barium titanate (BT) has received much attention in bone tissue engineering applications due to its biocompatibility and ability to maintain charged surfaces. However, its processability is poor and it does not have the biological activity to promote mineralization, which limits its use in bone repair. In this paper, a composite bone scaffold with excellent piezoelectric properties was prepared by combining 20 wt% calcium silicate. The influence of the light curing process on the properties of the piezoelectric biological scaffold was investigated by comparing it with the traditional piezoelectric ceramic molding method (dry pressing). Despite the structural features of 3D printing (layered structure, pore features), the piezoelectric and mechanical properties of the scaffold are weakened. However, 3D-printed scaffolds can combine structural and piezoelectric properties, which makes the 3D-printed scaffold more effective in terms of degradation and antibacterial performance. In terms of cell activity, piezoelectric properties attract proteins and nutrients into the scaffold, promoting cell growth and differentiation. Besides, it is undeniable that the pore structure of the scaffolds plays an important role in the biological properties. Finally, the 3D printed scaffolds have excellent antimicrobial properties due to the redox reaction under piezoelectric effect as well as structural characterization.

Silver doped barium titanate nanoparticles for enhanced visible light photocatalytic degradation of dyes.

Due to the rapid growth of global population, new, fast and reliable methods must be developed to purify contaminated water. Various photocatalysts have been developed to remove organic dyes from water. Herein, Ag doped BaTiO3 has been synthesized using a facile solvothermal method and its excellent photocatalytic activities were demonstrated in degradation of both anionic and cationic dyes under visible light illumination. Ag doped BaTiO3 nanoparticles showed greater efficacy in the degradation of methylene blue (MB) and eosin yellow (EY) than undoped BaTiO3 nanoparticles, which makes them a better candidate for photocatalysis. 1.0 AgBT sample showed the highest photocatalytic activity for MB (99.1 % in 100 min) and EY (99.3 % in 60 min) dye degradation compared with those of other samples. Further, the trapping experiments revealed that hydroxyl radicals and holes are the active species in the photocatalytic process of MB and EY dye degradation and recycle test showed excellent stability of the synthesized material.

Jejunal perforation and septic abdomen resulting from a choristoma in a dog.

A 4.6-year-old spayed female German shepherd dog was admitted to a specialty hospital emergency service upon referral for suspected gastrointestinal foreign body obstruction. Free abdominal fluid was collected, and results of cytologic evaluation were consistent with a septic abdomen. An abdominal barium study revealed free gas and intraperitoneal barium, along with an obstructive gas pattern within the small bowel. Ultrasonography revealed a full-thickness jejunal perforation. On exploratory laparotomy, the perforation was noted to be located mid-jejunum with no associated mass or foreign material. A resection and anastomosis were completed. Histopathologic evaluation of the affected jejunal tissue showed aberrant gastric glandular epithelium consistent with a gastric choristoma, or heterotopic gastric tissue. Key clinical message: Clinicians should consider gastric glandular choristoma as a differential diagnosis in cases of seemingly idiopathic small intestinal perforation with no known cause (i.e., foreign body penetration, neoplasia, NSAID use), and histopathologic evaluation should always be done to obtain a definitive diagnosis.

Perforation jéjunale et abdomen septique résultant d'un choristome chez un chien. Une chienne berger allemand stérilisée âgée de 4,6 ans a été admise dans le service d'urgence d'un hôpital spécialisé après avoir été référée pour une suspicion d'obstruction gastro-intestinale par un corps étranger. Du liquide abdominal libre a été prélevé et les résultats de l'évaluation cytologique étaient compatibles avec un abdomen septique. Un examen abdominal à l'aide de baryum a révélé du gaz libre et du baryum intrapéritonéal, ainsi qu'un patron de gaz obstructif dans l'intestin grêle. L'échographie a révélé une perforation sur toute l'épaisseur jéjunale. Lors d'une laparotomie exploratoire, il a été constaté que la perforation était située au milieu du jéjunum, sans masse ni corps étranger associé. Une résection et une anastomose ont été réalisées. L'évaluation histopathologique du tissu jéjunal affecté a montré un épithélium glandulaire gastrique aberrant compatible avec un choristome gastrique ou un tissu gastrique hétérotopique.Message clinique clé :Les cliniciens doivent considérer le choristome glandulaire gastrique comme diagnostic différentiel dans les cas de perforation de l'intestin grêle apparemment idiopathique sans cause connue (i.e. pénétration d'un corps étranger, néoplasie, utilisation d'AINS), et une évaluation histopathologique doit toujours être effectuée pour obtenir un diagnostic définitif.(Traduit par Dr Serge Messier).

A novel gelatinized barium sulfate injection method for assessment of bronchoalveolar lavage parameters.

INTRODUCTION: Bronchoalveolar lavage (BAL) is frequently used in pulmonary medicine though it requires further optimization. Practical obstacles such as patient safety and procedural limitation have to date precluded large, controlled trials aimed at standardization of BAL procedure. Indeed, BAL guidelines are based on observational data. Innovative research methods are necessary to advance the clinical practice of BAL. METHODS: In our study, we evaluated the effect of injecting a gelatinized barium solution into different lobes and segments of cadaveric lungs. As the technique requires an irreversible injection into lung airspaces, it is not suitable for in vivo purposes. We measured the volume returned from BAL as well as the distribution of BAL injection via dissection. Segmental anatomic orientation was compared to a radiologist's impression of plain film radiographs taken of injected lungs. RESULTS: Mean injected volume distributions were greatest in the upper lobes and lowest in the lower lobes; mean ratios of injected volume distribution to lung lobe volume also followed this trend. Cannulated bronchi orders favored lower branches in the upper lobe and higher branches in the lower lobes. Segmental anatomy varied by the lung lobe injected and was most varied in the lower lobes. CONCLUSION: This novel gelatinized-barium injection technique provides a minimally complex method to yield clinically meaningful feedback on the performance of BAL. The technique is also adaptable to study of procedural parameters in the context of variable lung anatomies and pathologies.

Flexural strength and translucency of barium-silicate-filled resin nanoceramics for additive manufacturing.

OBJECTIVE: This in vitro study aimed to evaluate the flexural strength (FS) and translucency parameter (TP) of resin nanoceramics (RNCs) with barium silicate for additive manufacturing. MATERIALS AND METHODS: An RNC slurry was prepared by mixing a barium silicate filler and resin monomer. For the FS tests, specimens with three filler contents (0, 50, and 63 wt%) were designed according to ISO6872 for dental ceramics and ISO10477 for dental polymers. These specimens were then formed into discs with thicknesses of 1 and 2 mm for TP measurement. RESULTS: In the specimens prepared according to ISO6872, the FS increased significantly depending on the filler content. However, in the case of ISO10477, there was no significant difference between the FSs of the specimens with 0 and 50 wt% filler contents. The increase in thickness affected translucency, and the lowest translucency was obtained at a filler content of 63 wt%. The filler distribution was dense in the specimen with 63 wt% filler and uniform but relatively sparse in the specimen with 50 wt% filler. More voids were observed in the specimen with 63 wt% filler. The thickness and filler content of the specimen affected its TP. The TP of the specimen with 63 wt% filler was similar to that of human enamel. CONCLUSION: The FS was significantly higher at a filler content of 63 wt%. The lowest translucency was obtained at a filler content of 63 wt% for all tested thicknesses. CLINICAL SIGNIFICANCE: Increasing the filler content was advantageous for the mechanical properties of the RNCs. A high filler content led to low translucency in the RNCs. Therefore, the esthetics of human teeth can be reproduced if layering according to the filler content is performed in areas where esthetic characteristics are required.

Polyvinylpyrrolidone-coated catheters decrease choroid plexus adhesion and improve flow/pressure performance in an in vitro model of hydrocephalus.

PURPOSE: Proximal catheter obstruction is the leading cause of ventricular shunt failure in pediatric patients. Our aim is to evaluate various types of shunt catheters to assess in vitro cellular adhesion and obstruction. METHODS: Four catheter types were tested: (1) antibiotic and impregnated, (2) barium-stripe polyvinylpyrrolidone coated (PVP), (3) barium-stripe, and (4) barium-impregnated. Catheters were seeded with choroid plexus epithelial cells to test cellular adhesion and inoculated with the same cells to test flow/pressure performance under choroid plexus growth conditions. Ventricular catheters were placed into a three-dimensional printed phantom ventricular replicating system through which artificial cerebrospinal fluid (CSF) was pumped. Differential pressure sensors were used to measure catheter performance. RESULTS: PVP catheters had the lowest median cell attachment (10 cells) compared to antibiotic-impregnated (230 cells), barium stripe (513 cells), and barium-impregnated (146 cells) catheters after culture (p < 0.01). In addition, PVP catheters (- 0.247 cm H2O) and antibiotic-impregnated (- 1.15 cm H2O) catheters had significantly lower pressure in the phantom ventricular system compared to the barium stripe (0.167 cm H2O) and barium-impregnated (0.618 cm H2O; p < 0.01) catheters. CONCLUSIONS: PVP catheters showed less cellular adhesion and, together with antibiotic-impregnated catheters, required less differential pressure to maintain a consistent flow. Our findings suggest clinical relevance for using PVP ventricular catheters in patients with recurrent catheter obstruction by choroid plexus.

Hiatal hernia reporting: time to remove subjectivity?

INTRODUCTION: The size of a hiatal hernia (HH) is a key determinant of the approach for surgical repair. However, endoscopists will often utilize subjective terms, such as "small," "medium," and "large," without any standardized objective correlations. The aim of this study was to identify HHs described using objective axial length measurements versus subjective size allocations and compare them to their corresponding manometry and barium swallow studies. METHODS AND PROCEDURES: Retrospective chart reviews were conducted on 93 patients diagnosed endoscopically with HHs between 2017 and 2021 at Newton-Wellesley Hospital. Information was collected regarding their HH subjective size assessment, axial length measurement (cm), manometry results, and barium swallow readings. Linear regression models were used to analyze the correlation between the objective endoscopic axial length measurements and manometry measurements. Ordered logistic regression models were used to correlate the ordinal endoscopic and barium swallow subjective size allocations with the continuous axial length measurements and manometry measurements. RESULTS: Of the 93 endoscopy reports, 42 included a subjective size estimate, 38 had axial length measurement, and 12 gave both. Of the 34 barium swallow reads, only one gave an objective HH size measurement. Axial length measurements were significantly correlated with the manometry measurements (R2 = 0.0957, p = 0.049). The endoscopic subjective size estimates were also closely related to the manometry measurements (R2 = 0.0543, p = 0.0164). Conversely, the subjective size estimates from barium swallow reads were not significantly correlated with the endoscopic axial length measurements (R2 = 0.0143, p = 0.366), endoscopic subjective size estimates (R2 = 0.0481, p = 0.0986), or the manometry measurements (R2 = 0.0418, p = 0.0738). Mesh placement was significantly correlated to pre-operative endoscopic axial length measurement (p = 0.0001), endoscopic subjective size estimate (p = 0.0301), and barium swallow read (p = 0.0211). However, mesh placement was not significantly correlated with pre-operative manometry measurements (0.2227). CONCLUSIONS: Endoscopic subjective size allocations and objective axial length measurements are associated with pre-operative objective measurements and intra-operative decisions, suggesting both can be used to guide clinical decision making. However, including axial length measurements in endoscopy reports can improve outcomes reporting.

Palladium-Catalyzed Hydrogenation of Black Barium Titanate for Multienzyme-Piezoelectric Synergetic Tumor Therapy.

Piezocatalytic tumor therapy is an emerging reactive oxygen species (ROS)-generating therapeutic approach that relies on piezoelectric polarization under ultrasound (US) irradiation. Optimizing ROS production is a primary objective for enhancing treatment efficiency. In this study, oxygen-vacancy-rich Pd-integrated black barium titanate (BTO) nanoparticles are rationally engineered to boost the ROS generation efficiency via the introduction of Pd. Pd-catalyzed hydrogenation at low temperatures narrows the bandgap of BTO and reduces the recombination rate of electron-hole pairs. Furthermore, Pd has dual-enzyme-mimicking characteristics, including peroxidase- and catalase-mimicking activities, which further heighten the therapeutic efficacy by enhancing ROS production and reversing the hypoxic tumor microenvironment. Importantly, the dual enzymatic activity of Pd can be amplified by multiple redox processes sparked by the piezoelectric potential under US stimulation, resulting in bilaterally enhanced multienzyme-piezoelectric synergetic therapy. In vitro and in vivo results confirm high tumor inhibition in murine breast cancer cells. This work stresses the critical effects of defect engineering-optimized piezodynamic tumor therapy.

The Value of Fundoplication in the Treatment of Type I Achalasia.

BACKGROUND: Type I achalasia comprises 20% of achalasia and has nearly absent esophageal motor activity. Concerns that fundoplication decreases the effectiveness of Heller myotomy in these patients has increased adoption of peroral endoscopic myotomy (POEM). Hence, we compared outcomes after Heller myotomy with Dor fundoplication vs POEM. METHODS: From 2005 to 2020, 150 patients with type I achalasia underwent primary surgical myotomy (117 Heller myotomy, 33 POEM). Patient demographics, prior treatments, timed barium esophagrams, Eckardt scores, and reinterventions were assessed between the 2 groups. Median follow-up was 5 years for Heller myotomy and 2.5 years for POEM. RESULTS: The Heller myotomy group was younger, had fewer comorbidities, and lower body mass index vs POEM. Risk-adjusted models demonstrated clinical success (Eckardt ≤3) in 83% of Heller myotomies and 87% of POEMs at 3 years; longitudinal complete timed barium esophagram emptying and reintervention were also similar. An abnormal pH test result was documented in 10% (6 of 60) after Heller myotomy and in 45% (10 of 22) after POEM (P < .001). CONCLUSIONS: Despite nearly absent esophageal contractility, Heller myotomy with Dor fundoplication and POEM result in similar long-term symptom relief, esophageal emptying, and occurrence of reintervention in patients with type I achalasia. There is decreased esophageal acid exposure with the addition of a fundoplication, without compromised esophageal drainage, allaying fears of a detrimental effect of a fundoplication. Hence, choice of procedure may be personalized based on patient characteristics and esophageal morphology and not solely on manometric subtype.