Exploring Citronella's inhibitory mechanism against Listeria monocytogenes and its utilization in preserving cheese.

Listeria monocytogenes presents significant risk to human health due to its high resistance and capacity to form toxin-producing biofilms that contaminate food. The objective of this study was to assess the inhibitory effect of citronella aldehyde (CIT) on L. monocytogenes and investigate the underlying mechanism of inhibition. The results indicated that the minimum inhibitory concentration (MIC) and Minimum sterilisation concentration (MBC) of CIT against L. monocytogenes was 2 µL/mL. At this concentration, CIT was able to effectively suppress biofilm formation and reduce metabolic activity. Crystalline violet staining and MTT reaction demonstrated that CIT was able to inhibit biofilm formation and reduce bacterial cell activity. Furthermore, the motility assessment assay revealed that CIT inhibited bacterial swarming and swimming. Scanning electron microscopy (SEM) and laser confocal microscopy (LSCM) observations revealed that CIT had a significant detrimental effect on L. monocytogenes cell structure and biofilm integrity. LSCM also observed that nucleic acids of L. monocytogenes were damaged in the CIT-treated group, along with an increase in bacterial extracellular nucleic acid leakage. The proteomic results also confirmed the ability of CIT to affect the expression of proteins related to processes including metabolism, DNA replication and repair, transcription and biofilm formation in L. monocytogenes. Consistent with the proteomics results are ATPase activity and ATP content of L. monocytogenes were significantly reduced following treatment with various concentrations of CIT. Notably, CIT showed good inhibitory activity against L. monocytogenes on cheese via fumigation at 4 °C.This study establishes a foundation for the potential application of CIT in food safety control.

Polysaccharide Peptide Treatment Eliminates Strawberry Viruses and Promotes Strawberry Plant Growth and Rooting in Tissue Culture Media.

Based on our previous finding that polysaccharide peptide (PSP) has substantial antiviral activity, we cultured strawberry plants infected with strawberry mild yellow edge virus (SMYEV) or strawberry vein banding virus (SVBV) in Murashige and Skoog (MS) media supplemented with PSP to test its ability to eliminate these viruses. PSP not only improved the elimination of SMYEV and SVBV but also promoted the growth and rooting of strawberry plants in tissue culture. On the 45th day, the average height of the 'Ningyu' strawberry plants in the 1-mg/ml PSP treatment group was 1.91 cm, whereas that of the plants in the control group was 1.51 cm. After the same time point, the number of new leaves on the tissue culture media supplemented with 1 mg/ml and 500 µg/ml of PSP and without PSP were 4.92, 4.41, and 3.53, respectively. PSP also promoted strawberry rooting and significantly increased both the length and number of roots. In addition, after treatment with the 1-mg/ml PSP treatment in tissue culture for 45 days followed by meristem-shoot-tip culture, the elimination rates of SMYEV and SVBV in regenerated 'Ningyu' strawberry plants ranged from 60 to 100%. This study investigated the use of the antiviral agent PSP for virus elimination. PSP has a low production cost and thus has great application potential for virus elimination in crop plants.

Translation and validation of traditional Chinese version of the pediatric eating assessment Tool-10.

BACKGROUND: /Purpose: The Pediatric Eating Assessment Tool-10 (Pedi-EAT-10) is a caregiver-administrated subjective questionnaire for evaluating swallowing and feeding disorders among children. This study translated the Pedi-EAT-10 into Traditional Chinese and tested the translated version's reliability and validity. METHODS: Pedi-EAT-10 was translated into Traditional Chinese by experts and finalized after discussion and testing. A total of 168 participants, consisting of 32 children with dysphagia from a tertiary medical center and 136 healthy controls from its Children Care Center for Employees, were recruited. All participants were assessed by an otolaryngologist and speech-language pathologist. The reliability, validity, and efficacy of the translated Pedi-EAT-10 were analyzed to ensure it could be used to identify pediatric dysphagia and feeding problems. RESULTS: The Traditional Chinese version of the Pedi-EAT-10 had significant clinical discriminative validity between the dysphagia group and the control group (total score = 9.6 vs. 2.6, P < 0.001), acceptable test-retest reliability (intraclass correlation = 0.63), and excellent internal consistency (Cronbach's α = 0.91 for the entire cohort). The overall performance of the test for distinguishing children with dysphagia from normal controls was acceptable, and the area under the curve was 74.8% (sensitivity = 71.9%; specificity = 69.9%). The optimal cutoff score was ≥3 on the Youdex index. CONCLUSIONS: The Traditional Chinese version of the Pedi-EAT-10 has fair reliability and validity and can be quickly and easily completed by caregivers. The translated Ped-EAT-10 can be used as a first-line tool for assessing the need for further referral and instrumental examination.

Experimental study for visualizing CO2-dissolved water plume migration under hydraulic gradient conditions and implication for field monitoring data.

Investigating the possible direction of a CO2-dissolved water plume migration near the potential CO2 leakage area is a significant task because it helps estimate the spatial and temporal monitoring scale to detect the signal of released CO2 from the storage. Accordingly, the Korea CO2 Storage Environmental Management (K-COSEM) research center tried to develop an intensive monitoring system and applied it to the artificial CO2 release test in the actual field. Monitoring data from the field tests depicted the horizontal movement of the CO2-dissolved water plume along the direction of the groundwater flow. However, it remains unclear how the CO2-dissolved water plume migrates vertically and how gas accumulation occurs near the capillary zone. The present study simulated the CO2 release test with a visual expression method utilizing a Hele-Shaw cell with hydraulic gradient conditions (i = 0, 0.1, and 0.01) and tried to estimate the significant influences on a diffusive-advective transport of the dissolved gas plume with the shallow aquifer condition. The visualization experiment results were intuitively verified to determine whether the theoretical principles of action related to plume flow applied in this context. The results suggest that a CO2-dissolved water plume is distributed by hydraulic gradients and density-driven CO2 convective flow. The plume shape, center, and area were analyzed using an image analyzer program; the results demonstrated that the plume characteristic evolved depending on the significant effects on the plume. When the plume was mainly affected by the hydraulic gradient, it rapidly moved from the injection point to the last boundary; in contrast, when it was influenced primarily by density-driven CO2 convective flow, it flowed diagonally downward in the shape of varied branches. The numerical model calculated the migration of the CO2-dissolved water plume affected by both factors. The laboratory experiment and numerical simulation results suggest that the migration of a CO2-dissolved water plume may be affected by the hydraulic gradient and density-driven CO2 convective transport. As such, these factors should be considered when designing and analyzing CO2 monitoring signals to detect CO2 leaks from shallow aquifer systems.

Computational fluid dynamics study in children with obstructive sleep apnea.

OBJECTIVES: This study aims to identify characteristics in image-based computational fluid dynamics (CFD) in children with obstructive sleep apnea (OSA). DESIGN: Diagnostic study. SETTING: Hospital-based cohort. PARTICIPANTS: Children with symptoms suggestive of OSA were recruited and underwent polysomnography. MAIN OUTCOME MEASURES: Three-dimensional models of computational fluid dynamics were derived from cone-beam computed tomography. RESULTS: A total of 68 children participated in the study (44 boys; mean age: 7.8 years), including 34 participants having moderate-to-severe OSA (apnea-hypopnea index [AHI] greater than 5 events/h), and 34 age, gender, and body mass index percentile matched participants having primary snoring (AHI less than 1). Children with moderate-to-severe OSA had a significantly higher total airway pressure (166.3 vs. 39.1 Pa, p = .009), total airway resistance (9851 vs. 2060 Newton-metre, p = .004) and velocity at a minimal cross-sectional area (65.7 vs. 8.8 metre per second, p = .017) than those with primary snoring. The optimal cut-off points for moderate-to-severe OSA were 46.2 Pa in the total airway pressure (area under the curve [AUC] = 73.2%), 2373 Newton-metre in the total airway resistance (AUC = 72.5%) and 12.6 metres per second in the velocity at a minimal cross-sectional area (AUC = 70.5%). The conditional logistic regression model revealed that total airway pressure, total airway resistance and velocity at minimal cross-sectional area were significantly associated with an increased risk of moderate-to-severe OSA. CONCLUSIONS: This study demonstrates that CFD could be a useful tool for evaluating upper airway patency in children with OSA.

Efficacy of adenotonsillectomy on pediatric obstructive sleep apnea and related outcomes: A narrative review of current evidence.

This review summarizes the current evidence in systematic reviews, meta-analysis and randomized controlled trials regarding adenotonsillectomy outcomes in pediatric obstructive sleep apnea (OSA). Adenotonsillectomy is effective in treating OSA in children without co-morbidities, despite postoperative residual OSA remained in roughly half of these children. For children with comorbidities such as Down syndrome, Prader-Willi syndrome, sickle cell disease, or cerebral palsy, adenotonsillectomy is less effective and associated with more postoperative complications than that in children without comorbidities. For other OSA-related outcomes, evidence from meta-analyses and randomized controlled trials confirm adenotonsillectomy results in improvement of subjective OSA-related outcomes (e.g. symptoms, behaviors, and quality of life), but the results in objective OSA-related outcomes (e.g. cardiometabolic parameters or neurocognitive functions) are inconsistent. Future studies should focus on randomized controlled trials comparing objective OSA-related outcomes and the long-term effects of adenotonsillectomy in children with OSA.

Revision of endoscopic sinus surgery in adults: A population-based study in Taiwan.

OBJECTIVE: This study aimed to elucidate the revision rate, time to revision, and factors associated with revision of endoscopic sinus surgery (ESS) in Taiwan. DESIGN: Retrospective study. SETTING: Population-based analysis. PARTICIPANT: We identified all in-hospital patients, aged >20 years, who underwent ESS between 2000 and 2008 from the Taiwan National Health Insurance Research Database, and followed up with them until 2018. MAIN OUTCOME MEASURES: Factors associated with revision surgery were analyzed using multivariable Cox proportional hazard model. RESULTS: Overall, 66 592 patients were identified (mean age, 46.3 years; 62% males). The revision rate was 14.5% (9644/66 592) and time to revision surgery was 5.9 years. Multivariable Cox proportional hazard model showed that young age, male gender (hazard ratio [HR] = 1.18; 95% confidence interval [CI], 1.13-1.23), having nasal polyposis (HR = 1.17; 95% CI, 1.12-1.22), having allergic rhinitis (HR = 1.08; 95% CI, 1.04-1.13), having asthma (HR = 1.26; 95% CI, 1.14-1.39), and surgical time of >4 h (HR = 1.11; 95% CI, 1.06-1.16) were associated with increased risk of revision surgery. Concurrent septal surgery (HR = 0.81; 95% CI, 0.76-0.87), turbinate surgery (HR = 0.91; 95% CI, 0.85-0.97), or septal and turbinate surgery (HR = 0.68; 95% CI, 0.64-0.73) were associated with decreased risks of revision surgery. CONCLUSION: In Taiwan, risk factors for revision ESS are young age, male gender, having nasal polyposis, having allergic rhinitis, having asthma, and long surgical times. Concurrent septal or turbinate surgery decreases the risk of revision.

Office Blood Pressure Monitoring in Children with Obesity and Obstructive Sleep Apnea.

OBJECTIVE: To investigate the relative contributions of obesity and obstructive sleep apnea (OSA) to unfavorable blood pressure in children. STUDY DESIGN: Children aged 3-18 years with OSA-related symptoms were recruited. All children underwent office blood pressure (BP) monitoring and full-night polysomnography. Obesity was defined as a body mass index ≥95th percentile. OSA severity was divided into primary snoring (apnea-hypopnea index [AHI] <1), mild OSA (5> AHI ≥1), and moderate to severe OSA (AHI ≥5). Age- and sex-adjusted logistic regression analysis was performed to determine the associations among OSA, obesity, and elevated BP. RESULTS: This cross-sectional study enrolled 1689 children (66% boys), with a mean age of 7.9 years. Compared with children with primary snoring, children with moderate to severe OSA had significantly higher systolic BP (108.1 mmHg vs 105.6 mmHg), diastolic BP (75.0 mmHg vs 70.4 mmHg), systolic BP percentile (75.0 vs 70.4), and diastolic BP percentile (74.0 vs 69.2). The rate of unfavorable BP (ie, elevated BP or hypertension level BP) also was significantly higher in children with more severe OSA. Children with obesity had higher BP and BP percentile. Logistic regression analysis revealed that children with obesity and moderate to severe OSA have a 3-fold greater risk of unfavorable BP compared with children without obesity and primary snoring. CONCLUSIONS: We identified a 3-fold greater risk of unfavorable BP in children with obesity and moderate to severe OSA.

Prevalence of sleep disorders in children with chronic kidney disease: a meta-analysis.

BACKGROUND: The reported prevalence of sleep disorders in children with chronic kidney disease (CKD) varies greatly. A quantitative meta-analysis to estimate the prevalence of sleep disorders among pediatric CKD patients may provide further information. OBJECTIVES: The objective of this study is to estimate the prevalence of sleep disorders in children with CKD. The study protocol was registered on PROSPERO (registration number CRD42021268378). DATA SOURCES: Two authors independently searched the PubMed, MEDLINE, EMBASE, and Cochrane review databases up to June 2021. STUDY ELIGIBILITY CRITERIA: Eligible studies include data of prevalence of sleep disorders in children with CKD. STUDY APPRAISAL AND SYNTHESIS METHODS: The prevalence of restless legs syndrome, sleep-disordered breathing, pediatric obstructive sleep apnea (i.e., apnea-hypopnea index > 1 event/h in polysomnography), excessive daytime sleepiness, and insomnia/insufficient sleep was estimated using a random-effects model. Subgroup analyses were conducted to compare the prevalence of sleep disorders between children on dialysis and not on dialysis. This meta-analysis included 12 studies with 595 children (mean age: 12.9 years; gender ratio: 55.6% boys; mean sample size: 49.6 patients). RESULTS: The prevalence of restless legs syndrome in children with CKD was 21% (95% confidence interval [CI], 14-30%). The prevalence of sleep-disordered breathing, pediatric obstructive sleep apnea, excessive daytime sleepiness, and insomnia/insufficient sleep was 22% (95% CI, 12-36%), 34% (95% CI, 19-53%), 27% (95% CI, 17-41%), and 14% (95% CI, 7-27%), respectively. Subgroup analysis revealed the pooled prevalence of excessive daytime sleepiness was significantly higher in children on dialysis than in children not on dialysis (43.3% vs. 11.2%; P = 0.018). Children on dialysis also had a high prevalence of other sleeping disorders, although the differences did not reach statistical significance. Children with CKD exhibited a 3.9-fold (95% CI, 1.37 to 10.93) increased risk of restless legs syndrome and a 9.6-fold (95% CI, 3.57 to 25.76) increased risk of excessive daytime sleepiness compared with controls. LIMITATIONS: The selected papers are of small sample size, lack of a control group, and exhibit substantial heterogeneity. CONCLUSIONS: Sleep disorders are common in children with CKD. Our results indicate that while the prevalence rates of various sleep disorders were higher in children on dialysis than in children not on dialysis, the prevalence of excessive daytime sleepiness was statistically significant in children on dialysis. A higher resolution version of the Graphical abstract is available as Supplementary information.

Effects of dry yeast supplementation on growth performance, rumen fermentation characteristics, slaughter performance and microbial communities in beef cattle.

This study aimed to investigate the effects of active dry yeast (ADY) on growth performance, rumen microbial composition and carcass performance of beef cattle. Thirty-two finishing beef cattle (yak ♂ × cattle-yaks ♀), with an average body weight of 110 ± 12.85 kg, were randomly assigned to one of four treatments: the low plane of nutrition group (control), low plane of nutrition group + ADY 2 g/head daily (ADY2), low plane of nutrition group + ADY 4 g/head daily (ADY4) and the high plane of nutrition group (HPN). Supplementation of ADY increased average daily gain compared to the control group. The neutral detergent fiber and acid detergent fiber apparent digestibility in HPN group was greater than that in control group. The propionic acid concentration in the rumen in ADY2, ADY4, and HPN groups was greater than that in control group. The Simpson and Shannon indexes in control and HPN groups were higher than that in ADY4 group. At the phylum level, the relative abundance of Firmicutes in the HPN group was higher than that in ADY4 group. The relative abundance of Ruminococcaceae UCG-002 in ADY4 group was higher than that in control and HPN groups. In conclusion, supplementation ADY 4 g/head daily shift the rumen microbial composition of beef cattle fed low plane of nutrition to a more similar composition with cattle fed with HPN diet and produce the similar carcass weight with HPN diet.HighlightsThe ADY can improve the utilization of nitrogen and decrease the negative impact on the environment in beef cattle.Cattle fed low plane of nutrition diet supplemented with ADY 4 g/head daily increased growth performance.Supplementation ADY 4 g/head daily in low plane of nutrition diet might be produced comparable carcass weight to HPN diet.

Effect of sleep surgery on lipid profiles in adults with obstructive sleep apnea: a meta-analysis.

PURPOSE: The effects of sleep surgery on the lipid profile of adults diagnosed as having obstructive sleep apnea (OSA) remain unclear. This meta-analysis aimed to clarify whether sleep surgeries improve patients' lipid profile. METHODS: The study protocol was registered on PROSPERO (CRD42020154425). Two authors independently searched the PubMed, MEDLINE, EMBASE, and Cochrane review databases up to September 2020 using keywords such as sleep apnea, OSA, sleep apnea syndromes, lipids, and surgery. The effects of sleep surgery on the apnea-hypopnea index (AHI) and lipid profile parameters were evaluated using a random-effects model. RESULTS: Thirteen studies were included, with a total of 710 patients (mean age: 42.0 years; 85% men; mean sample size: 54.6 patients). The summary estimate of AHI change was - 20.6 events/h (95% CI - 25.9 to - 15.3) and the Epworth Sleepiness Scale score was - 4.2 (95% CI - 5.9 to - 2.5). Sleep surgery lowered total cholesterol (mean - 7.7 mg/dL; 95% CI - 12.2 to - 3.2), low-density lipoprotein (mean - 7.2 mg/dL; 95% CI - 11.0 to - 3.3), and triglyceride (mean - 14.0 mg/dL; 95% CI - 22.2 to - 5.8) levels but did not affect high-density lipoprotein (mean 1.5 mg/dL; 95% CI - 0.6 to 3.7) levels. Subgroup analysis revealed that the lipid profile changes were not associated with the surgical procedure but with the degree of OSA improvement. Meta-regression analyses demonstrated that the improvement in the lipid profile was positively correlated with AHI reduction. CONCLUSION: Surgeries for OSA may improve the lipid profile, which is positively correlated with the degree of OSA improvement.

Controlled Synthesis of Palladium Nanoparticles with Size-Dependent Catalytic Activities Enabled by Organic Molecular Cages.

Particle size plays a key role in the performance of metal nanoparticles (MNPs). However, the size-controlled synthesis of MNPs still represents a challenging task. In this work, we revealed a strong solvent effect on the growth of palladium nanoparticles (PdNPs), which was directed by a porous [2 + 3] organic molecular cage (OMC, Phos-cage) containing triphenylphosphine moieties. PdNPs with different average diameters of 0.8, 1.2, and 3.3 nm supported by Phos-cage were obtained by simply varying the reaction media. The catalytic performance of such ultrafine PdNPs in the reduction of p-nitrophenol and a Suzuki-Miyaura coupling reaction has been studied, which clearly shows size-dependent catalytic activity and stability. The knowledge gained in this study, controlling the size of PdNPs supported by the OMC template in different solvents, will open new possibilities for size-controlled synthesis of ultrafine MNPs with high catalytic activity and stability.

Phosphine-Based Covalent Organic Framework for the Controlled Synthesis of Broad-Scope Ultrafine Nanoparticles.

In this work, a phosphine-based covalent organic framework (Phos-COF-1) is successfully synthesized and employed as a template for the confined growth of broad-scope nanoparticles (NPs). Ascribed to the ordered distribution of phosphine coordination sites in the well-defined pores, various stable and well-dispersed ultrafine metal NPs including Pd, Pt, Au, and bimetallic PdAuNPs with narrow size distributions are successfully prepared as determined by transmission electron microscopy, X-ray photoelectron spectroscopy, inductively coupled plasma, and powder X-ray diffraction analyses. It is also demonstrated that the as-prepared Phos-COF-1-supported ultrafine NPs exhibit excellent catalytic activities and recyclability toward the Suzuki-Miyaura coupling reaction, reduction of nitro-phenol and 1-bromo-4-nitrobenzene, and even tandem coupling and reduction of p-nitroiodobenzene. This work will open many new possibilities for preparing COF-supported ultrafine NPs with good dispersity and stability for a broad range of applications.

Reproducing natural variations in CO2 concentration in vadose zone wells with observed atmospheric pressure and groundwater data.

Continuous CO2 gas monitoring was performed to understand the natural variations of the gas concentration in the vadose zone wells. The monitoring results demonstrated sudden rise and fall signals, which posed a possibility of error in interpreting the CO2 leaking signal from the sequestrating reservoir or evaluating the quantity of removed VOCs at a contaminated site. Based on the monitoring data, conceptual models were established and three cases were numerically simulated to determine whether or not reproducing the natural variations of gas concentration is possible. The simulated numerical model indicated that the atmospheric pressure and groundwater level data should be considered together, rather just only one boundary condition each (top or bottom). Reproducing the natural pattern of the target gas and understanding the gas flow and transport under real closed natural conditions would also be useful. The results demonstrated the need for numerical simulation to predict the natural pattern of the CO2 gas concentration before designing or performing actual CO2 release test or CO2 leakage monitoring in the wells of the vadose zone, as well as at the geologic carbon sequestration site.

Application of geographically weighted regression models to predict spatial characteristics of nitrate contamination: Implications for an effective groundwater management strategy.

Groundwater nitrate contamination has been the main water quality problem threatening the sustainable utilization of water resources in Jeju Island, South Korea. The spatially varying distribution of nitrate levels associated with complex environmental and anthropogenic factors has been a major challenge restricting improved groundwater management. In this study, we applied ordinary least squares (OLS) regression and geographically weighted regression (GWR) models to determine the relationships between the NO3-N concentration and various parameters (topography, hydrology and land use) across the island. A comparison between the OLS regression and GWR prediction models showed that the GWR models outperformed the OLS regression models, with a higher R2 and a lower corrected Akaike Information Criterion (AICc) value than the OLS regression models. Interestingly, the GWR model was able to provide undiscovered information that was not revealed in the OLS regression models. For example, the GWR model found that orchards (OR) and urban (UR) variables significantly contributed to nitrate enrichment in the certain parts of the island, whereas these variables were ignored as a statistically insignificant factor in the OLS regression model. Our study highlighted that GWR models are a useful tool for investigating spatially varying relationships between groundwater quality and environmental factors; therefore, it can be applied to establish advanced groundwater management plans by reflecting the spatial heterogeneity associated with environmental and anthropogenic conditions.

Ear, nose, and throat foreign bodies in adults: A population-based study in Taiwan.

BACKGROUND/PURPOSE: This study performed a population-based analysis in the managements of adult ear, nose, and throat FBs in Taiwan. METHODS: The Taiwan Longitudinal Health Insurance Database 2000 were used, which comprises 1,000,000 beneficiaries randomly sampled in 2000 with a follow-up period from 2000 to 2013. Patients aged >18 years with ear, nose, or throat FB were identified according to the International Codes of Diseases. RESULTS: In total, 94,312 adults with ear (n = 21,786), nose (n = 1007), throat (n = 62,986), airway (n = 419), or esophageal (n = 8114) FB were identified. Emergency department visits were most common among patients with esophageal or airway FB (33.3% and 25.1%, respectively). X-rays were most commonly performed for patients with esophageal FB (44.8%), and computed tomography (CT) was most commonly used for those with airway FB (4.3%). Hospitalization rate was the highest among patients with airway FB (7.4%), followed by those with esophageal (3.0%) and nose (0.7%) FB. Patients with airway FBs corresponded with the highest rate of intensive care unit stay (58.1%), longest hospital stay (10.5 days), and highest in-hospital mortality rate (25.8%). A multiple logistic regression model indicated that old age, medical comorbidities, undergoing CT, and airway or esophageal FB were associated with hospitalization among adults with FB. CONCLUSION: Disparities were identified in the treatment of ear, nose, and throat FB in adults. This study provides population-based data that may serve as a reference for otolaryngologists in clinical FB management.

Real-time multi-level CO2 concentration monitoring in vadose zone wells and the implication for detecting leakage events.

Multi-level wells screened at different depths in the vadose zone were installed and used for CO2 and carbon isotope monitoring. Well CO2 time series data were collected along with subsurface and atmospheric parameters such as air pressure, temperature, wind speed, and moisture content. Our aim was to determine the natural factors affecting the variation of CO2 concentration and how the influence of these factors varies with time of day and seasons of the year. We were motivated to understand the cause and extent of CO2 natural fluctuations in vadose zone wells in order to separate natural variation from signals due to anthropogenic CO2 leaks anticipating future monitoring using these wells. Variations of seasonal mean and variance of CO2 concentrations at different depths seem to follow the diurnal trend of subsurface temperature changes that reflect the atmospheric temperature but with time delay and amplitude damping due to heat transport considerations. The temperature in the ground lags behind the change in the atmospheric temperature, thus, the deeper the depth, the longer the time delay and the smaller the amplitude of the change. Monitored seasonal variation as shown in Appendix A shows the temperature-dependent depth-dependent CO2 production in the soil zone indicating higher CO2 concentrations in the summer and fall seasons with high concentrations ranging between 10,990 and 51,600 ppm from spring to summer, and 40,100 and 17,760 ppm from fall to winter. As the temperature in the organic-rich topsoil layer changes from daytime to nighttime, the concentration of CO2 in the soils also changes dynamically in response to chemical and biological reactions. When a screened well is installed in the vadose zone the dynamic temporal and depth difference in CO2 production is further complicated by upward (out of the subsurface) or downward (into the subsurface) gas flow, which will amplify or attenuate the temporal and vertical biochemically produced differences. Nested wells screened at different depths in the vadose zone and wells fully screened through the vadose zone were used for comparison. In addition, experiments changing the well from open to surface air to sealed at the top were conducted. The flow rates of inhaled (downward) and exhaled (upward) gas were estimated based on multi-level monitoring data. Based on time-series monitoring data, we proposed a time-dependent conceptual model to explain the changes of CO2 concentration in wells. The conceptual model was tested through analytical model computations. This conceptual model of natural variation of CO2 will be helpful in utilizing the vadose zone well as a method for monitoring CO2 leakage from subsurface storage or anthropogenic CO2 -producing activities.

24-Hour Ambulatory Blood Pressure after Adenotonsillectomy in Childhood Sleep Apnea.

OBJECTIVE: To assess the effects of adenotonsillectomy (T&A) on ambulatory blood pressure (ABP) in childhood obstructive sleep apnea (OSA). STUDY DESIGN: From 2012 to 2017, children aged 4-16 years with symptoms and polysomnography-diagnosed OSA (apnea-hypopnea index [AHI] >1) underwent T&A. PSG studies and 24-hour ABP monitoring were performed before and at 3 months after surgery. RESULTS: In total, 159 children were enrolled (mean age, 7.8 ± 3.3 years; 72% male). T&A significantly reduced the AHI from 12.4 ± 15.9 events/hour to 2.7 ± 5.7 events/hour (P < .001). A decrease was observed in the children's overall diastolic blood pressure (65.1 ± 6.1 mm Hg to 63.8 ± 7.4 mm Hg, P = .04) after surgery. In subgroup analysis, 100 (63%) patients were classified as nonhypertensive, and 59 (37%) were classified as hypertensive. Linear mixed model analysis revealed that compared with the children without hypertension, those with hypertension had superior improvement in systolic and diastolic blood pressure during daytime and nighttime (all P values < .01). The ABP changes after surgery were not correlated with the AHI changes. Finally, preoperative hypertension was an independent risk factor of postoperative hypertension among these children (OR 3.66; 95% CI 1.70-7.86). CONCLUSIONS: Overall, in children with OSA, the 24-hour ABP change after T&A is small. However, among children with preoperative hypertension, there is significant BP improvement after T&A surgery.

Comparisons of Office and 24-Hour Ambulatory Blood Pressure Monitoring in Children with Obstructive Sleep Apnea.

OBJECTIVE: To compare office blood pressure (BP) and 24-hour ambulatory BP (ABP) monitoring to facilitate the diagnosis and management of hypertension in children with obstructive sleep apnea (OSA). STUDY DESIGN: Children aged 4-16 years with OSA-related symptoms were recruited from a tertiary referral medical center. All children underwent overnight polysomnography, office BP, and 24-hour ABP studies. Multiple linear regression analyses were applied to elucidate the association between the apnea-hypopnea index and BP. Correlation and consistency between office BP and 24-hour ABP were measured by Pearson correlation, intraclass correlation, and Bland-Altman analyses. RESULTS: In the 163 children enrolled (mean age, 8.2 ± 3.3 years; 67% male). The prevalence of systolic hypertension at night was significantly higher in children with moderate-to-severe OSA than in those with primary snoring (44.9% vs 16.1%, P = .006). Pearson correlation and intraclass correlation analyses revealed associations between office BP and 24-hour BP, and Bland-Altman analysis indicated an agreement between office and 24-hour BP measurements. However, multiple linear regression analyses demonstrated that 24-hour BP (nighttime systolic BP and mean arterial pressure), unlike office BP, was independently associated with the apnea-hypopnea index, after adjustment for adiposity variables. CONCLUSIONS: Twenty-four-hour ABP is more strongly correlated with OSA in children, compared with office BP.

Magnetic Resonance Imaging-Based Prostate-Specific Antigen Density for Prediction of Gleason Score Upgrade in Patients With Low-Risk Prostate Cancer on Initial Biopsy.

OBJECTIVE: The aim of this study was to assess the utility of prostate-specific antigen density (PSAD) calculated using magnetic resonance imaging for predicting Gleason score (GS) upgrade in patients with low-risk prostate cancer on biopsy. METHODS: Seventy-three patients were divided into 2 groups according to the concordance between biopsy and prostatectomy GS: group 1 (6/6) and group 2 (6/≥7). Magnetic resonance imaging-based PSAD, prostate volume, prostate-specific antigen (PSA), and age were compared between the 2 groups. Logistic regression and receiver operating characteristic curve analysis were performed. RESULTS: Gleason score was upgraded in 40 patients. Patients in group 2 had significantly higher PSAD and PSA values and smaller prostate volume than did those in group 1. Prostate-specific antigen density of 0.26 ng/mL per cm or higher, PSA of 7.63 ng/mL or higher, and prostate volume of 25.1 cm or less were related to GS upgrade, with area-under-the-curve values of 0.765, 0.721, and 0.639, respectively. CONCLUSIONS: Magnetic resonance imaging-based PSAD could help in predicting postoperative GS upgrade in patients with low-risk prostate cancer.