Water Catchers within Sub-Nano Channels Promote Step-by-Step Zinc-Ion Dehydration Enable Highly Efficient Aqueous Zinc-Metal Batteries

Zinc metal suffers from violent and long-lasting water-induced side reactions and uncontrollable dendritic Zn growth, which seriously reduce the coulombic efficiency (CE) and lifespan of aqueous zinc-metal batteries (AZMBs). To suppress the corresponding harmful effects of the highly active water, a stable zirconium-based metal-organic framework with water catchers decorated inside its sub-nano channels is used to protect Zn-metal. Water catchers within narrow channels can constantly trap water molecules from the solvated Zn-ions and facilitate step-by-step desolvation/dehydration, thereby promoting the formation of an aggregative electrolyte configuration, which consequently eliminates water-induced corrosion and side reactions. More importantly, the functionalized sub-nano channels also act as ion rectifiers and promote fast but even Zn-ions transport, thereby leading to a dendrite-free Zn metal. As a result, the protected Zn metal demonstrates an unprecedented cycling stability of more than 10 000 h and an ultra-high average CE of 99.92% during 4000 cycles. More inspiringly, a practical NH4V4O10//Zn pouch-cell is fabricated and delivers a capacity of 98 mAh (under high cathode mass loading of 25.7 mg cm-2) and preserves 86.2% capacity retention after 150 cycles. This new strategy in promoting highly reversible Zn metal anodes would spur the practical utilization of AZMBs.

Thermal-Accelerated Urease-Driven Bowl-Like Polydopamine Nanorobot for Targeted Photothermal/Photodynamic Antibiotic-Free Antibacterial Therapy

The problem of antibiotic resistance seriously affects the treatment of bacterial infections, so there is an urgent need to develop novel antibiotic-independent antimicrobial strategies. Herein, a urease-driven bowl-like mesoporous polydopamine nanorobot (MPDA@ICG@Ur@Man) based on single-wavelength near-infrared (NIR) remote photothermal acceleration to achieve antibiotic-free phototherapy(photothermal therapy, PTT, plus photodynamic therapy, PDT) is first reported. The smart nanorobots can perform active movement by decomposing urea to produce carbon dioxide and ammonia. Particularly, the elevated local temperature during PTT can increase urease activity to enhance the autonomous movement and thus increase the contact between the antimicrobial substance and bacteria. Compared with a nanomotor propelled by urea only, the diffusion coefficient (De) of photothermal-accelerated nanorobots is increased from 1.10 to 1.26 µm2 s-1. More importantly, urease-driven bowl-like nanorobots with photothermal enhancement can specifically identify Escherichia coli (E. coli) and achieve simultaneous PTT/PDT at a single wavelength with 99% antibactericidal activity in vitro. In a word, the urease-driven bowl-like nanorobots guided by photothermal-accelerated strategy could provide a novel perspective for increasing PTT/PDT antibacterial therapeutic efficacy and be promising for various antibiotic-free sterilization applications.

Diagnosis of spinal dural arteriovenous fistula: a multimodal MRI assessment strategy

AIM

To identify more specific screening indicators at magnetic resonance imaging (MRI) for the diagnosis of spinal dural arteriovenous fistulas (SDAVFs) and to determine an efficient diagnostic strategy.

MATERIALS AND METHODS

This retrospective study analysed clinical and imaging data of patients diagnosed with SDAVF and alternative myelopathy who underwent conventional MRI examinations. Additionally, three-dimensional (3D) T2-weighted sampling perfection with application-optimised contrasts using different flip-angle evolutions (3D-T2-SPACE) and contrast-enhanced magnetic resonance angiography (CE-MRA) data from patients with SDAVF were compared with digital subtraction angiography (DSA) data.

RESULTS

The age of onset, perimedullary flow voids (PFV), distribution of lesions, syringomyelia, degree of spinal oedema, and cauda equina disorder (CED) were factors that showed statistically significance in the identification of SDAVF with alternative myelopathy. After controlling for age, gender, PFV, degree of spinal cord swelling, and syringomyelia, the multivariable ordinal logistic regression model showed that the CED sign (OR = 32.46; 95% confidence interval [CI]: 2.47-427.15; p=0.008) was an independent predictor for SDAVF. The diagnostic model constructed using the PFV and CED signs had better diagnostic performance, with an area under the curve of 0.957 (p<0.001), maximum Youden index of 0.844, sensitivity of 92.9%, and specificity of 91.5%. Both 3D-T2-SPACE (77.8%) and CE-MRA (83.3%) sequences had good localisation values for SDAVF. Combining the two imaging examinations had better diagnostic accuracy than that of DSA.

CONCLUSION

CED and PFV on conventional MRI were specific indicators for the diagnosis of SDAVF. To compensate for the lack of fistula localisation on conventional MRI, 3D-T2-SPACE and CE-MRA can be used. Together they complement each other and have good diagnostic potential.

The value of 3D T2-weighted SPACE sequence in the differential diagnosis of spinal arteriovenous fistula and acute transverse myelitis

OBJECTIVE

Spinal arteriovenous fistulas (SAVF) was often neglected and misdiagnosed as acute transverse myelitis (ATM) due to its insidious onset and non-specific clinical symptoms. This study aims to investigate the differential diagnostic value of high-resolution T2-weighted volumetric sequence (3D sampling perfection with application-optimized contrasts using different flip-angle evolutions [SPACE]) in patients with SAVF and ATM.

METHODS

Retrospectively analyzed the clinical and radiological findings of 32 SDAVF patients and 32 ATM patients treated at our institutions from May 2018 to January 2023. They all underwent conventional spinal MRI and T2-SPACE examination, compared their performance in identifying lesions, to estimate the value of T2 SPACE sequence in the diagnosis of SAVF and ATM patients.

RESULTS

The clue of cauda equina area change (CEAC) in conventional MRI and T2-SPACE sequences is specific for the diagnosis of SAVF. The diagnostic model composed of perimedullary flow voids (PFV) and CEAC has good diagnostic performance (AUCMRI = 0.95; AUCSPACE = 0.935). Compared with conventional MRI, the T2-SPACE sequence has a higher detection rate, sensitivity, and negative predictive value for PFV and CEAC in SAVF patients, but lower specificity and positive predictive value. In T2-SPACE images, there are significant differences in the distribution range, quadrant, and maximum diameter of PFV vessels between SAVF and ATM patients. Moreover, T2-SPACE sequence can determine the site of fistula in most SAVF patients preferably, and the inter-rater agreement was good in the assessment of the fistula.

CONCLUSION

The CEAC is a new and useful clue for the diagnosis of thoracolumbar SAVF. And T2-SPACE sequence can more intuitively observe the lesions of SAVF, has good differential diagnostic value for SAVF and ATM patients.

Global taxonomic, functional, and phylogenetic diversity of bees in apple orchards

An essential prerequisite to safeguard pollinator species is characterisation of the multifaceted diversity of crop pollinators and identification of the drivers of pollinator community changes across biogeographical gradients. The extent to which intensive agriculture is associated with the homogenisation of biological communities at large spatial scales remains poorly understood. In this study, we investigated diversity drivers for 644 bee species/morphospecies in 177 commercial apple orchards across 33 countries and four global biogeographical biomes. Our findings reveal significant taxonomic dissimilarity among biogeographical zones. Interestingly, despite this dissimilarity, species from different zones share similar higher-level phylogenetic groups and similar ecological and behavioural traits (i.e. functional traits), likely due to habitat filtering caused by perennial monoculture systems managed intensively for crop production. Honey bee species dominated orchard communities, while other managed/manageable and wild species were collected in lower numbers. Moreover, the presence of herbaceous, uncultivated open areas and organic management practices were associated with increased wild bee diversity. Overall, our study sheds light on the importance of large-scale analyses contributing to the emerging fields of functional and phylogenetic diversity, which can be related to ecosystem function to promote biodiversity as a key asset in agroecosystems in the face of global change pressures.

Nitrogen-Fluorine co-doped TiO2/SiO2 nanoparticles for the photocatalytic degradation of acrylonitrile: Deactivation and regeneration

In this study, we investigated the deactivation kinetics and mechanism of N-F-TiO2/SiO2 nanopowder as a model photocatalyst for the purpose of facilitating the photocatalytic degradation of acrylonitrile (AN) in aqueous environment. Prior research has already displayed the proficient degradation of AN through the utilization of N-F-TiO2/SiO2 catalysts, revealing a degradation efficiency of 81.2% within a span of 6 min at an initial AN concentration of 10 mg/L. Multiple variables including the initial AN concentration, illumination intensity, and initial pH value were extensively analyzed during the degradation process. The kinetics of photocatalytic degradation of AN, facilitated by the N-F-TiO2/SiO2 photocatalyst, were modeled by fitting the pseudo first-order reaction kinetics to each individual factor. Furthermore, the adverse effect of catalyst poisoning during the photocatalytic breakdown of AN using the N-F-TiO2/SiO2 photocatalyst was analyzed through a range of different techniques including SEM, XPS, BET, XRD, TG, and NH3-TPD. The incorporation of findings from these diverse techniques revealed that, the primary factors contributing to the photocatalyst's poisoning were as follows: (i) During the degradation process, the build-up of intermediate molecules on active sites hindered their functionality, leading to a decrease in the efficiency of the photocatalytic reaction, (ii) Carbonaceous deposits formed when the catalyst's pore structure was obstructed by pollutants or intermediate products that had not undergone timely photocatalytic breakdown and (iii) The persistent erosion of active sites due to hydraulic forces resulted in inadequate performance of the N-F-TiO2/SiO2 photocatalyst in aqueous solutions. A comprehensive analysis of the deactivation kinetics was conducted, deciding in the formulation of a detailed poisoning mechanism for the N-F-TiO2/SiO2 photocatalyst. Additionally, we explored the catalysts regeneration, involving thermal treatment, ultrasonic irradiation, and catalyst reloading. This study not only advances our insight into the waning performance of catalysts in aqueous media but also establishes a conceptual framework for extrapolating analogous deactivation dynamics in other catalysts, grounded in precedent experimental knowledge. This research contributes to the development of a deactivation model for catalysts in the aqueous environment, based on existing experimental research, providing a theoretical framework for understanding the deactivation process of photocatalysts.

Association of intravascular enhancement sign on 3D-T1W TSE with collateral status in middle cerebral artery occlusion stroke

OBJECTIVE

The significance of the intravascular enhancement sign (IVES) on high-resolution magnetic resonance vascular wall imaging (HR-VWI) remains unclear. This study aimed to investigate the correlation between the IVES and collateral assessment derived from digital subtraction angiography (DSA).

METHOD

A total of 75 patients with occlusion of the first segment of the middle cerebral artery (MCA) who underwent HR-VWI and DSA examinations at our research institution between November 2016 and February 2023 were included. The number of vessels with IVES, IVES-Alberta Stroke Program Early Computed Tomography Score (ASPECTS), American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) collateral grade, and DSA collateral blood flow grade were retrospectively evaluated. Correlations between these indicators were assessed using Spearman's correlation.

RESULTS

Interrater agreement was good for the assessment of HR-VWI and DSA indicators. After adjustments for age, degree of wall enhancement, and hypertension, a multivariable ordinal logistic regression model identified both the number of IVES vessels (OR = 1.37; 95%CI [1.06-1.78]; P = 0.017) and IVES-ASPECTS (OR = 2.00; 95%CI [1.03-3.87]; P = 0.041) as independent predictors of ischemic stroke. In the patient group with acute ischemic stroke, we found weak correlations between the number of IVES vessels and the ASITN/SIR collateral grade (rho = -0.35; P = 0.002) and between the IVES-ASPECTS and ASITN/SIR collateral grade (rho = -0.27; P = 0.02). Moreover, there were strong correlations between the number of IVES vessels and the DSA collateral blood flow grade (rho = -0.74; P < 0.001) and between the IVES-ASPECTS and the DSA collateral blood flow grade (rho = -0.65; P < 0.001). The number of IVES vessels correlated strongly with the IVES-ASPECTS (rho = 0.92, P < 0.001).

CONCLUSION

We find that the IVES is closely associated with sluggish collateral blood flow, which further confirms the hemodynamic mechanism underlying the IVES in MCA occlusion.

Research on a Method of Locating Civil Aviation Radio Interference Sources Based on Time Difference of Arrival and Frequency Difference of Arrival for Four Unmanned Aerial Vehicles

Monitoring and analyzing radio interference sources play a crucial role in ensuring the safe operation of civil aviation navigation, communication, airport management, and air traffic control. Traditional ground monitoring methods are slow and inadequate for tracking aerial and mobile interference sources effectively. Although flight methods such as helicopters and airships can effectively monitor aerial interference, the flight approval process is time-consuming and expensive. This paper investigates a novel approach to locating civil aviation radio interference sources using four unmanned aerial vehicles (UAVs) to address this issue. It establishes a model for aerial positioning of radio interference sources with the four UAVs and proposes a method for time synchronization and data communication among them. The paper conducts simulations of the four-UAV time-frequency difference positioning method, analyzing the geometric accuracy dilution with different deployment configurations of the UAVs, positioning biases, and root mean square errors (RMSEs) under varying interference source movement speeds. The simulation results provide crucial data to support subsequent experiments.

Association of intravascular enhancement sign detected on high-resolution vessel wall imaging with ischaemic events in middle cerebral artery occlusion

PURPOSE

Patients with intracranial artery occlusion have high rates of ischaemic events and recurrence. Early identification of patients with high-risk factors is therefore beneficial for prevention. Here we assessed the association between the intravascular enhancement sign (IVES) on high-resolution vessel wall imaging (HR-VWI) and acute ischaemic stroke (AIS) in a population with middle cerebral artery (MCA) occlusion.

METHOD

We retrospectively analysed the records of 106 patients with 111 MCA occlusions, including 60 with and 51 without AIS, who had undergone HR-VWI and computed tomography angiography (CTA) examinations from November 2016 to February 2023. Numbers of IVES vessels were counted and compared to the CTA findings. Statistical analyses of demographic and medical data were also performed.

RESULTS

Occurrence rates and numbers of IVES vessels were significantly higher in the AIS than the non-AIS group (P < 0.05), and most vessels were detected on CTA. Numbers of vessels positively correlated with AIS occurrence (rho = 0.664; P < 0.0001). A multivariable ordinal logistic regression model adjusted for age, degree of wall enhancement, hypertension, and heart status identified the number of IVES vessels as an independent predictor for AIS (odds ratio = 1.6; 95% CI, 1.3-1.9; P < 0.0001).

CONCLUSION

Number of IVES vessels is an independent risk factor for AIS events, and may represent poor cerebral blood flow status and collateral compensation level. It thus provides cerebral haemodynamic information for patients with MCA occlusion for clinical use.

Modular and Selective Access to Functionalized Alkynes and Allenes via the Intermediacy of Propargylic Acetates

We report an efficient one-pot, two-step procedure for the modular synthesis of α-difunctionalized alkynes and trisubstituted allenes by sequential cross-coupling of benzal gem-diacetates with organozinc or -copper reagents in the absence of external transition metals. The intermediacy of propargylic acetates enables the divergent and selective synthesis of these valuable products. This method features its readily accessible substrates, relatively mild conditions, wide scope, and scalability in practical synthesis.

The value of next-generation sequencing for the diagnosis of Streptococcus suis meningitis

OBJECTIVE

The aim of this study was to investigate the value of next-generation sequencing for the diagnosis of Streptococcus suis meningitis.

METHODS

Patients with meningitis in the Department of Neurology of the Hainan General Hospital were recruited and divided into a next-generation sequencing group and a control group. In the next-generation sequencing group, we used the next-generation sequencing method to detect the specific pathogenic bacteria in the patients. In the control group, we used the cerebrospinal fluid bacterial culture method to detect the specific pathogenic bacteria in the patients.

RESULTS

A total of 28 participants were recruited for this study, with 14 participants in each group. The results showed similarities in both the average age and average course of the disease between the two groups (p>0.05). The white blood cell count, percentage of neutrophils, and level of C-reactive protein in the next-generation sequencing group were significantly higher than those in the control group (p<0.05). There were similarities in both the temperature and intracranial pressure between the two groups (p>0.05). In the next-generation sequencing group, all patients (100%) were detected as having had the S. suis meningitis infection by next-generation sequencing, while only 6 (43%) patients in the control group had been detected as having the S. suis meningitis infection by cerebrospinal fluid bacterial culture.

CONCLUSIONS

The positive detection rate of S. suis by the next-generation sequencing method was significantly higher compared with using a cerebrospinal fluid bacterial culture. Therefore, the next-generation sequencing method is valuable for the diagnosis of S. suis meningitis and is worthy of clinical application.

Altered functional connectivity of the thalamus in primary angle-closure glaucoma patients: A resting-state fMRI study

Background and objectives

Glaucoma is one of the leading irreversible causes of blindness worldwide, and previous studies have shown that there is abnormal functional connectivity (FC) in the visual cortex of glaucoma patients. The thalamus is a relay nucleus for visual signals; however, it is not yet clear how the FC of the thalamus is altered in glaucoma. This study investigated the alterations in thalamic FC in patients with primary angle-closure glaucoma (PACG) by using resting-state functional MRI (rs-fMRI). We hypothesized that PACG patients have abnormal FC between the thalamus and visual as well as extravisual brain regions.

Methods

Clinically confirmed PACG patients and age- and gender-matched healthy controls (HCs) were evaluated by T1 anatomical and functional MRI on a 3 T scanner. Thirty-four PACG patients and 33 HCs were included in the rs-fMRI analysis. All PACG patients underwent complete ophthalmological examinations; included retinal nerve fiber layer thickness (RNFLT), intraocular pressure (IOP), average cup-to-disc ratio (A-C/D), and vertical cup-to-disc ratio (V-C/D). After the MRI data were preprocessed, the bilateral thalamus was chosen as the seed point; and the differences in resting-state FC between groups were evaluated. The brain regions that significantly differed between PACG patients and HCs were identified, and the correlations were then evaluated between the FC coefficients of these regions and clinical variables.

Results

Compared with the HCs, the PACG patients showed decreased FC between the bilateral thalamus and right transverse temporal gyrus, between the bilateral thalamus and left anterior cingulate cortex, and between the left thalamus and left insula. Concurrently, increased FC was found between the bilateral thalamus and left superior frontal gyrus in PACG patients. The FC between the bilateral thalamus and left superior frontal gyrus was positively correlated with RNFLT and negatively correlated with the A-C/D and V-C/D. The FC between the left thalamus and left insula was negatively correlated with IOP.

Conclusion

Extensive abnormal resting-state functional connections between the thalamus and visual and extravisual brain areas were found in PACG patients, and there were certain correlations with clinical variables, suggesting that abnormal thalamic FC plays an important role in the progression of PACG.

Acute and long-term success of left atrial anterior line and mitral isthmus line ablation in patients after mitral valve surgery

Background

Perimitral flutter and atrial fibrillation may occur in patients with prior surgical mitral valve (MV) repair or replacement and can be challenging for percutaneous catheter ablation.

Objective

This study sought to determine the feasibility, acute success and durability of catheter ablation of atrial fibrillation or atrial tachycardia by way of a mitral isthmus line (MIL) or an anterior line (AL).

Methods

A total of 81 patients (49 males, mean age 62±11 years) with prior MV replacement (n=30) or repair (n=51) underwent creation of a MIL (n=34) and/or an AL (n=72). Control group patients without prior surgery were matched 1:1 with the valve group (MIL, n=34; AL, n=72).

Results

Acute bidirectional block of the MIL was successfully achieved in 24/34 cases and of the AL in 64/72 patients with prior MV surgery. In the control group, acute bidirectional block was achieved in 31/34 MIL patients and 65/72 AL patients. In terms of durability, the MIL valve subgroup showed the poorest results (probability of long-term failure 2.224, as opposed to 0.605 in the MIL control subgroup; hazard ratio [HR]=0.27, 95% confidence interval [CI], 0.11–0.65; p=0.004). In the AL subgroups, long-term outcomes were similar (probability of failure in AL valve subgroup 0.844 vs. AL control subgroup 1.03; HR=1.22, 95% CI, 0.66–2.26; p=0.523).

Conclusions

Percutaneous creation of MIL and AL is feasible and safe in patients with prior MV replacement/repair. Because of poor long-term outcomes, MIL creation appears not advisable in patient with prior MV surgery.

Funding Acknowledgement

Type of funding sources: None.

Improvement of sulfur and water resistance with Fe-modified S-MnCoCe/Ti/Si catalyst for low-temperature selective catalytic reduction of NO with NH3

The low-temperature SCR of NO_x by NH₃ is restricted in application since the catalysts is easily poisoned by sulfur and water. The Fe modified Mn-Co-Ce/TiO₂/SiO₂ catalysts synthesized via impregnation method and sulfating were evaluated for low-temperature NH₃-SCR in the presence of SO₂ and H₂O. The calcination temperature and loading amounts of Mn, Fe, Co and Ce were optimized. Adding of Fe into S-MnCoCe/Ti/Si played an important role in resistance to sulfur and water poisoning. The optimal calcination temperature was 380 °C and the optical mass loading of the catalyst was 10% of Mn, 10% of Fe, 1% of Co and 4% of Ce. The optimal S-MnFeCoCe/Ti/Si catalyst maintained high NO_x conversion of 93% at reaction temperature of 160 °C in the presence of 50 ppm SO₂ and 10 vol% H₂O. The catalytic activity did not continue to fall after two times of repeated used in the temperature range of 100-200 °C, indicating its excellent sulfur and water durability and stability in the presence of SO₂ and H₂O. The interaction between MnO_x and FeO_x enhanced sulfur and water durability rather than other bi-metal interactions. Furthermore, the mechanism of Fe improving resistance to SO₂ and H₂O was discussed.

Enhanced photo-hypoxia-activated combination therapy traced by AIE photosensitizer and targeted by hyaluronic acid: Disulphide bond interference of detoxification barrier

The treatment efficacy of anticancer drugs in complex physiological environments is still restricted by multi-drug resistance. To overcome this issue, a nanodrug system of HA-SS@CuS@ZIF-8@TPZ&TBMACN (HSCZTT) that breaks through the detoxification barrier for tirapazamine (TPZ) delivery was developed in this manuscript. In addition to the photothermal effect aroused by CuS in HSCZTT, which can damage tumour cells, TBMACN with photostable fluorescence in the aggregate state can also generate sufficient reactive oxygen species (ROS) to destroy tumour cells. The continuous consumption of oxygen in PDT aggravates the hypoxic environment of tumours, which further activates the TPZ released in the acidic microenvironment of the tumour to achieve apoptosis of the tumour cells. The HSCZTT can not only target the CD44 receptor overexpressed on the surface of the cancer cell, but can also effectively consume a large amount of glutathione (GSH) through the disulphide bond-modified hyaluronic acid, which serves as a targeted disulphide bond, interfering with the detoxification barrier. Our finding presents a rational strategy to overcome multidrug resistance for the improved efficacy of anticancer drugs by the targeting of Hyaluronic acid (HA), release of the drug by the acid response of ZIF-8, breakthrough of the detoxification barrier, precise positioning of the drug release and combined treatment with phototherapy and hypoxia-activated chemotherapy.

Why are redo AF ablations required and what does it take? Type of index PVI predicts pattern of redo ablations

Funding Acknowledgements

Type of funding sources: None.

Background

Catheter ablation targeting isolation of the pulmonary veins (PVI) is the most effective treatment for atrial fibrillation (AF). Despite its high overall effectiveness, repeat AF ablations (re-do procedures, RDP) are often required to maintain sinus rhythm.

Purpose

Determine predictors for multiple and/or complex RDP, evaluate reference values for procedure duration and radiation exposure during index PVI (iPVI) and nth RDP in a large cohort.

Methods and Results

Data mining identified 934 (mean age 62.6 ± 12.3 years, 346 females) out of 6848 total AF ablation patients from a large German AF ablation center between 09/2008 and 09/2021 with an index PVI and at least one RDP. Analysis included 2152 procedures (out of 8750 total AF-related ablations). At iPVI, AF pattern was classified as paroxysmal AF (PAF) in 387 patients (41%). All others (59%) were classified as non-paroxysmal AF (Non-PAF). Non-PAF was significantly more frequent in males (64% vs. 49%, p&lt;0.01). Median period between first PVI and RDP was 558 days (25th/75th percentiles 244.0/1175.5 days). Non-PAF patients had a significantly higher probability of multiple RDP compared to patients with PAF at iPVI (p&lt;0.01, Figure 1A). 18% (8%) of patients with non-PAF had 2 (3) or more RDP while only 13% (3%) of pat. with PAF had 2 (3) or more RDP.

iPVI was classified as PVI-only or PVI with additional substrate modification (SM). 724/934 patients (78%) received PVI-only as initial procedure. Of these, 572 (79%) had only 1 RDP, 116 (16%) had 2 RDP and 36 (5%) had 3 or more RDP. This distribution was 77%, 15% and 8% for 1, 2 and 3 or more RDP for patients with complex PVI as iPVI.

An algorithm based on regular expressions classified all RDP as repeat PVI (Re-PVI) due to reconduction (PV reconduction), ablation of atrial tachycardia (AT) or SM, e. g. defragmentation of fractionated signals, or combinations. The results were manually quality-controlled. 798/934 (85%) patients required PV re-isolation due to PV reconduction, 298/934 (32%) required ablation for atrial tachycardia (AT) at least once during FU (Figure 1B). Comparing PVI-only iPVI patients with patients who received substrate modification during iPVI, significantly less patients with PVI-only iPVI had RDP for AT compared to those with SM during iPVI (27% vs. 50%, p&lt;0.01). More PVI-only iPVI patients required PV-reisolation at any time during FU (87% vs 79%, p&lt;0.01). Considering PVI-only (+/- CTI) iPVIs only, dose-area product decreased in RDP compared to first PVI, while procedure duration slightly increased (Figure 1C). Data on periprocedural complications will be reported.

Conclusion

Redo AF ablations procedures are mainly required due to reconnected pulmonary veins or AT. Patients with PAF at iPVI are less likely to require more than one RDP which provides indirect support for early rhythm control in treatment of AF. SM at iPVI might be a predictor for occurrence of AT in the further course.

Comparison of left atrial lesion size and troponin release of two novel single shot devices for pulmonary vein isolation: pulsed field ablation vs. multi-electrode radiofrequency balloon

Funding Acknowledgements

Type of funding sources: None.

Introduction

Pulsed-field ablation (PFA) and the multi-electrode radiofrequency balloon (RFB) are two novel ablation technologies to perform pulmonary vein isolation (PVI). It is currently unknown whether these technologies differ in lesion formation and lesion extent.

Purpose

We compared the acute lesion extent after PVI induced by PFA and RFB by measuring low-voltage area in high-density maps and the release of biomolecules reflecting cardiac injury.

Methods

PVI was performed with a pentaspline catheter (FARAPULSE) applying PFA or with the compliant multi-electrode radiofrequency balloon (HELIOSTAR). Before and after PVI high-density mapping with CARTO3 was performed. In addition, blood samples were taken before transseptal puncture and after post-PVI remapping. Serum concentrations of high-sensitive Troponin I (hsTropI) were quantified by Immunoassay.

Results

50 patients undergoing PVI by PFA (n=26, age 71±10 y, 58% males, 58% persistent AF) or RFB (n=24; age 64±13 y, 54% males, 25% persistent AF) were evaluated. Acute PVI was achieved in all patients in both groups. Mean number of PFA pulses were n=34±5 and mean number RFB applications were n=8±3. Total posterior ablation area was bigger in PFA (19.0±6.2 cm²) than in RFB (9.0±2.2 cm²; p&lt;0.001). The posterior distance between septal and lateral lesions was shorter in PFA (23.7±10.5 mm) than in RFB (30.0±7.3 mm; p=0.021). In a total of 38 patients increase of hsTropI was higher after PFA (625±138 pg/ml, n=28) vs. RFB (148±36 pg/ml; n=10; p=0.049) supporting the evidence of larger lesion extent by PFA.

Conclusion

Pulse-field ablation delivers larger acute lesion areas and higher troponin release upon successful pulmonary vein isolation than multi-electrode array balloon-based pulmonary vein isolation in this single-center series.

Safety of pulsed-field ablation in patients with cardiac implantable electronic devices. A single-center pilot study

Funding Acknowledgements

Type of funding sources: None.

Introduction

Pulsed-field ablation (PFA) is a novel energy source to perform pulmonary vein isolation (PVI) in patients with atrial fibrillation or cavo-tricuspid isthmus ablation (CTI) in patients with atrial flutter. Whether strong electrical fields generated by PFA could change the function and integrity of cardiac implantable electronic devices (CIED) is not known.

Aim

To assess the function and integrity of implanted devices before and after pulsed-field ablation.

Methods

This study included consecutive patients with CIED undergoing PFA at a large single center. Real-time CIED electrograms were recorded during PFA applications. CIED were interrogated before and after PFA assessing function (threshold, sensing), integrity (impedance), and arrhythmia episodes.

Results

We performed PFA in six patients (age 69±12 years, 1/6 female, left atrial diameter was 44±3 mm, left-ventricular ejection fraction 40±14%) for PVI in five patients with atrial fibrillation and CTI ablation in one patient with atrial flutter. All patients had CIEDs (one cardiac resynchronization device, two implantable cardioverter-defibrillators, three two-chamber pacemakers). Each patient undergoing PVI received 32 PFA applications of 2.5 s. (4x basket configuration and 4x flower configuration at each pulmonary vein), amounting to a total ablation time of 80 s and resulting in complete PVI in all five patients. For CTI ablation we applied 8 PFA applications of 2.5 s (20 s total ablation time) resulting in CTI blockade. Real-time intracardiac electrograms (iEGM) during PFA applications revealed sensing of single PFA application impulses in three patients and blanking of the iEGM in three patients. Postinterventional device testing revealed no changes in impedance, stimulation threshold or sensing. No leads were dislocated or damaged. No other device malfunctions occurred during the procedure, as well as no other major periprocedural complications occurred.

Conclusion

The function and integrity of pacemakers and defibrillators is not affected by PFA in our patient sample. Larger series are needed to confirm the apparent safety of PFA in patients with CIED.

Pulmonary vein isolation by pulsed-field ablation induces smaller neurocardiac damage than cryoballoon ablation

Funding Acknowledgements

Type of funding sources: Private company. Main funding source(s): FARAPULSE, Inc.

Introduction

Thermal energy sources damage the entire atrial tissue during pulmonary vein isolation (PVI) including cardiac nerves and ganglia. This induces a postinterventional increase in heart rate. Pulsed-field ablation (PFA), a new non-thermal energy source for PVI, primarily damages cardiomyocytes by electroporation. Whether use of PFA reduces damage to cardiac nerves and ganglia and influences postinterventional increase of heart rate is not known.

Purpose

We compared the acute effects of PFA with a pentaspline catheter and cryoballoon ablation (CBA) on secretion of circulating biomolecules reflecting cardiomyocyte and neuronal injury and postinterventional increase in heart rate to estimate damage to the cardiac autonomic nervous system and autonomic dysfunction after PVI.

Methods

Blood samples were taken before and after PVI in consecutive patients undergoing PFA and CBA. All patients participated in the TRUST registry. Serum concentrations of high-sensitive Troponin I (hsTropI, Immunoassay) and S100b (ELISA), a surrogate marker for neuronal injury, were quantified in blood samples taken prior to PVI and directly after PVI. Pre- and postinterventional heart rates were measured in ECGs and Holter-ECGs.

Results

Fifty-six patients underwent PVI, either by PFA (n=28, age 63 [54; 75] y, 64% males, 57% persistent AF) or CBA (n=28, age 71 [62; 78] y, 61% males, 54% persistent AF). All 112 blood samples were analyzable. Acute success of PVI was 100% in both groups without major complications, especially, no TIA and no stroke. After CBA, one patient suffered from phrenic palsy, which reversed after 3 months. HsTropI increased 3.3-fold more after PFA compared to CBA (625±138 vs. 185±42 pg/ml; p=0.004) suggesting more damage to cardiomyocytyes. S100b increased 2.9-fold less after PFA compared to CBA (21.1±3.7 vs. 61.2±8.1 pg/ml; p&lt;0.001). The ratio of ∆S100b/∆hsTropI was five-fold smaller after PFA compared to CBA (0.19±0.1 vs. 0.98±0.3; p=0.007), suggesting a lower neurocardiac injury in comparison to lesion size. Concomitantly, increase in heart rate at the postinterventional day was smaller in PFA (-0.2±3.0 bpm; n=45) than in CBA (+6.1±2.7 bpm, n=15; p=0.024).

Conclusion

This study in patients validates the experimental concept that PFA-based AF ablation leads to more specific damage to cardiomyocytes than to cardiac nerves and ganglia, reflected by lower S100B concentrations and no post-interventional heart rate increase compared to CBA.

Catheter ablation of the mitral isthmus line using the novel DiamondTemp ablation system: first experience using two different ablation protocols

Funding Acknowledgements

Type of funding sources: None.

Background

Mitral ishmus ablation is an established approach to treat perimitral reentrant tachycardia, and is often performed as substrat modification in patients with persistent atrial fibrillation (AF). Bidirectional block of the mitral isthmus line (MIL) is still a great challenge using conventional ablation catheters, but is essential to prevent recurrence of atrial arrhythmia.

Recently, the novel DiamondTempTM (DT) ablation system was introduced and allows for high-power, short-duration ablation in a temperature-controlled mode. Its use during pulmonary vein isolation (PVI) using a recommended ablation setting with a catheter-tip temperature limit of 60°C, a temperature-controlled power of 50 W and an application duration of 10 sec has shown to be effective and safe. However, data on DT ablation settings for substrate modification, i.e., creation of linear lesions are lacking.

Aim

The aim of the present study was to evaluate acute efficacy and safety of the novel DT ablation system for bidirectional block of the MIL using two different protocols.

Methods

The study population comprised 14 patients [67±8 years, 10/14 male (71%)] suffering from persistent AF and/or atrial tachycardia who underwent catheter re-ablation with creation of a MIL using the DT ablation system. Ablation settings were a catheter-tip temperature limit of 60°C, a temperature-controlled power of 50 W with an application duration of either 10 sec (group A, n=7) or 20 sec (group B, n=7). Additional epicardial ablation from within the coronary sinus with a temperature limit of 60°C, a temperature-controlled power of 20 W and an application duration of 20 sec was performed, if bidirectional block could not be achieved with endocardial ablation only.

Results

Mean procedure and fluoroscopy time, and dose area product for group A and group B were 103±24 vs. 119±38 min, 12±5 vs. 13±4 min, and 572±270 vs. 537±202 cGycm, respectively. Bidirectional block of the MIL was achieved in 7/7 (100%) patients in group A and in 6/7 (86%) patients in group B. Additional epicardial ablation was required in 6/7 patients (86%) in group A and in 4/7 (57%) patients in group B. In group B, bidirectional block of the MIL required fewer endocardial (31±11 vs. 26±10 applications) as well as epicardial RF-applications (10±6 vs. 7±3 applications). Pericardial effusion without hemodynamic relevance occurred in 1/7 (14%) patients of group B. No further complications occurred.

Conclusion

Catheter ablation of the MIL using the novel DT ablation system is safe and associated with high acute efficacy. A lower number of RF-applications and a less frequent need for additional epicardial ablation was observed when applying longer RF-applications of 20 sec. Further analyses are warranted to confirm these findings.

Optimizing catheter ablation of atrial fibrillation by a novel wide-band dielectric imaging system: first experience on real-time wall thickness measurement

Funding Acknowledgements

Type of funding sources: None.

Background

Conventional mapping systems do not provide wall-thickness data, which is, however, known to be a determinant of radiofrequency ablation lesion transmurality. KODEX-EPD is a novel open-platform system, which uses dielectric tissue properties to provide real-time, high-resolution cardiac images, tissue characteristics and wall-thickness measurement to guide ablation procedures.

Aim

The aim of this case series was to report on our first experiences with KODEX-EPD regarding estimation of myocardial wall-thickness during catheter ablation of atrial fibrillation (AF).

Methods

We retrospectively analyzed consecutive patients undergoing radiofrequency AF-ablation in combination with KODEX-EPD. A high-resolution image from the left atrium (LA) and the pulmonary veins (PV) was obtained prior to ablation using a spiral mapping catheter in conjunction with KODEX-EPD. Wall-viewer points were collected within the LA, the PVs and the left atrial appendage (LAA) using a standard radiofrequency non-contact force ablation catheter and analyzed for wall-thickness applying the latest KODEX-EPD software version (1.5.0, not yet commercially released). Wall-viewer points were divided into a total of 10 segments (PV ostia, anterior wall, posterior wall, LA roof, LA floor, LAA and PV carina, details see Figure 1) in order to characterize wall-thickness in respective areas.

Results

A total of 570 wall-viewer points in 5 patients were analyzed. Most of the wall-viewer points were collected at the PV ostia as well as along the posterior and anterior wall (449/570, 79%). Actual myocardial atrial thickness ranged from 1.6 to 3.9 mm. Thickest myocardial LA-tissue was measured at the anterior wall (median 3.1 mm) and thinnest at the LA-roof (median 2.2 mm). Figure 2 gives a detailed distribution of wall-thickness measurements at different sites in the LA and PVs.

Conclusion

Atrial wall thickness can be estimated in patients during AF ablation procedures using dielectric tissue properties. Further evaluation and validation of the method are needed to study its reliability and utility for clinical practice.

Structure modification and biological evaluation of indole-chalcone derivatives as anti-tumor agents through dual targeting tubulin and TrxR

Microtubule target agents (MTAs) are widely-used clinical anti-cancer drugs for decades, but the acquired drug resistance severely restricted their application. Thioredoxin reductases (TrxR) was reported to be overexpressed in most tumors and closely related to high risk of cancer recurrence and drug resistance, making it a potential target for anticancer drug discovery. Multi-target-directed ligands (MTDLs) by a single molecule provide a logical and alternative approach to drug combinations. In this work, based on the structure-activity relationships obtained in our previous study, some structure modifications were performed. On one hand, the retained skeleton structure of MTAs endowed its tubulin polymerization inhibition activity, on the other hand, the selenium-containing structure and α,β-unsaturated ketone moiety endowed the TrxR inhibition activity. As results, the newly obtained compounds exhibited superior anti-proliferative activities towards various human cancer cells and drug-resistance cells, and displayed high selectivity towards various human normal cells. The mechanism study revealed that the dual effect of cell cycle arrest triggered by targeting tubulin and the abnormal accumulation of ROS caused by TrxR inhibition eventually lead to cell apoptosis. Notably, compared with the MTA agents CA-4P, and the TrxR inhibitor Ethaselen, the optimized compound 14c, which served as dual-targeting inhibitor of tubulin and TrxR, exerted greatly improved in vivo anti-tumor activity. In summary, 14c deserved further consideration for cancer therapy.

Accuracy and acute efficacy of a novel occlusion tool to guide cryoballoon-based pulmonary vein isolation

Background

Cryoballoon (CB)-based pulmonary vein isolation (PVI) currently requires to verify occlusion of each pulmonary vein (PV) using fluoroscopy and dye injection.

Objective

The current study evaluated whether the novel CB-occlusion tool integrated into the wide-band dielectric imaging system KODEX-EPD reliably verifies occlusion of PV according to a novel dye-injection based algorithm.

Methods

Consecutive patients suffering from symptomatic atrial fibrillation (AF) underwent CB-based PVI using the KODEX-EPD and the novel occlusion-tool (group I). To confirm accurate display of the PVs, selective PV-angiography was performed in the first half of the patients of group I (group Ia) in addition to a three-dimensional left atrial (LA) map using a spiral mapping catheter (Achieve, SMC1, Medtronic, MN, USA). PV-angiographies were waived for the following patients (group Ib). Procedural duration and radiation exposure were compared to a control group of patients undergoing conventional CB-based PVI.

Results

CB-based PVI was successful in 50/50 patients of group I (mean age 63±11 years, 18 paroxysmal (36%)) and 25/25 patients of group II (66±10 years, 9 paroxysmal (60%)). Concordance of PV-occlusion as assessed by either PV-occlusion-angiography or KODEX-EPD, was documented in 237/272 (87%) occlusion-analyses among 198 PVs (95% for left superior PV, 93% for left inferior PV, 86% for right inferior PV and 77% for right superior PV).

In the final evaluation phase (group Ib) LA fluoroscopy times and dose area products were comparable to the conventional CB-ablation group (10.5±5 vs 8.8±4 minutes (p=0.23) and 403±425 vs 321±202 cGycm2 (p=0.44), whereas the amount of dye could be significantly reduced (group Ib: 31±10 ml vs group II: 70±20 ml, p&lt;0.0001).

Conclusion

The novel KODEX-EPD PV-occlusion tool allows for accurate PV-occlusion assessment in the majority of PVs and a high acute success rate. The system has the potential to reduce dye and radiation exposure. This should be evaluated in controlled clinical trials.

Funding Acknowledgement

Type of funding sources: None.

Photocatalytic degradation of industrial acrylonitrile wastewater by F-S-Bi-TiO2 catalyst of ultrafine nanoparticles dispersed with SiO2 under natural sunlight

Highly active photocatalyst, having certain anti-ionic interfering function, of F, S and Bi doped TiO2/SiO2 was used for the first time to degrade the organic pollutants in acrylonitrile industrial wastewater under natural sunlight. The photocatalyst were prepared and characterized by UV-Vis, XRD, TEM, EDS, Nitrogen physical adsorption and XPS technique. UV-Vis analysis revealed addition of F, S and Bi into the lattice of TiO2 led to the expansion of TiO2 response in the visible region and hence the efficient separation of charge carrier. The photocatalytic potential of as prepared catalyst to degrade acrylonitrile wastewater under simulated and natural sunlight irradiation was investigated. The extent of degradation of acrylonitrile wastewater was evaluated by chemical oxygen demand (CODCr). CODCr in wastewater decreased from 88.36 to 7.20 mgL-1 via 14 h irradiation of simulated sunlight and achieved regulation discharge by 6 h under natural sunlight, illuminating our photocatalyst effectiveness for refractory industrial wastewater treatment. From TEM results, we found that SiO2 could disperse the photocatalyst with different component distributions between the surface and the bulk phase that should also be responsible for the light absorption and excellent photocatalytic performance. The XPS analysis confirmed the presence of surface hydroxyl group, oxygen vacancies.

P1361Impact of radiation/chemotherapy for breast cancer on the electroanatomic features in patients receiving catheter ablation for left atrial arrhythmia

Background

Atrial fibrillation (AF) is a common cardiac arrhythmia and catheter ablation a viable treatment option for patients with AF. Extensive left atrial (LA) scars, frequently seen in patients with persistent AF, can limit its efficacy. Radiation for breast cancer treatment is known to have serious long-term effects (e.g. fibrosis) on the targeted tissue. At the same time, chemotherapy often leads to organ dysfunction. We sought to examine the effects of radiation and chemotherapy on the electroanatomic features of the LA in patients who received catheter ablation for left atrial arrhythmias with prior breast cancer treatment.

Methods and Results

We compared 38 patients (mean age 68.4 ± 7.1 years) who underwent catheter ablation for LA arrhythmia and had a previous diagnosis of breast cancer with 38 patients (mean age 65.4 ± 7.3 years) without breast cancer who formed our control group. LA scar area, as well as its distribution was measured during the electrophysiology (EP) study and graded according to the Utah classification.

The existence of LA scarring did not differ significantly between both groups (71.1% vs. 76.3%, p = 0.602). LA scar area (excluding PVs) was 107.5cm2 ± 19.0cm2 in the breast cancer group compared to 110.1cm2 ± 18.5cm2 in the control group (p = 0.536). The distribution of the scar area revealed no significant difference between both groups, however an involvement of the anterior wall was common (65.8% vs. 73.7%; p = 0.454). We further investigated whether the location of breast cancer had an impact on the LA scar development of the patients in our study cohort. Here, we found no significant difference in the amount of LA scarring when comparing patients with left-sided breast cancer to patients with right-sided breast cancer (66.7% vs. 73.9%). In a sub-analysis patients with breast cancer and persistent AF showed a non-significant trend towards greater LA scar areas (17.4cm2 vs. 6.8cm2) in comparison to patients of the control group with similar LA volumes.

The patient’s age (&gt;65 years) was the only independent predictor for greater LA scarring we could identify. Neither former radiotherapy, nor chemotherapy showed a positive correlation with greater LA scarring.

Conclusion

There is no change in the distribution as well as an increase of the extent of LA scars after thoracic irradiation and/or chemotherapy. A trend towards greater LA scar areas was seen in patients with breast cancer and persistent AF. The patient’s age was identified as an independent predictor for LA scar development.

Efficient photocatalytic degradation of acrylonitrile by Sulfur-Bismuth co-doped F-TiO2/SiO2 nanopowder

In this study, a simple sol-gel method was applied for preparing effectual photocatalyst of S-Bi co-doped F-TiO₂/SiO₂ (S-Bi-F-TiO₂/SiO₂) nanopowder. Optimal preparation conditions were obtained by optimizing the calcination temperature and the ratio of S and Bi. The synthesized powder was characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), energy dispersive spectrometer (EDS), X-ray photoelectron spectroscopy (XPS), brunauer-emmett-teller (BET), UV-Visible diffuse-reflectance spectroscopy (UV-Vis DRS), photoluminescence spectroscopy (PL) and ammonia adsorption and temperature-programmed desorption (NH₃-TPD). The photocatalytic activity was evaluated by the degradation of acrylonitrile under simulated visible light irradiation. S-Bi-F-TiO₂/SiO₂ nanopowder possess excellent photocatalytic properties under visible light for the degradation of acrylonitrile, when the calcination temperature was 450 °C for 2 h and the ratio of S and Bi was 0.02: 0.007. The degradation efficiency of acrylonitrile reached to 81.9% within 6 min of visible light irradiation. Compared with F-TiO₂/SiO₂ sample, NH₃-TPD and PL results revealed the higher photocatalytic activity for S-Bi-F-TiO₂/SiO₂, which is mainly due to the increase strength and number of surface acid site with S doping. The co-doping with S & Bi improved the separation of electron-hole pairs and enhanced the photocatalytic oxidizing species. The UV-Vis DRS showed stronger absorption in S-Bi co-doped F-TiO₂/SiO₂ catalyst as compared to F-TiO₂/SiO₂ catalyst. XPS results demonstrated the presence of various surface species viz. oxygen vacancies, Ti³⁺, Ti⁴⁺, O^2- and OH group.

Adsorption and photocatalytic degradation of benzene compounds on acidic F-TiO2/SiO2 catalyst

The adsorption and photocatalytic degradation performance of F-TiO₂/SiO₂ catalyst towards a series of benzene compounds were studied. The results revealed that the F-TiO₂/SiO₂ catalyst is superior to TiO₂ P25 in adsorption capacity and photocatalytic degradation under simulant sunlight irradiation. The adsorptive capacity for chlorobenzene is the highest and the degradation rate is the greatest among these target pollutants. The increase of absorptive organic molecules on acidic F-TiO₂/SiO₂ catalyst benefits photocatalytic degradation. The photocatalytic reaction accords to Langmuir-Hinshelwood mechanism. The FTIR results indicated that the promoting effect of acidic centers on adsorption of benzene compounds depends on electron property of the functional groups. The electron-donating groups (-OH and -NH₂) of benzene compounds are weakly adsorbed on acidic centers of the catalyst due to the competitive adsorption with H₂O, while the electron-withdrawing groups (-Cl and -NO₂) are adsorbed more strongly at acidic sites. The monosubstituted chlorobenzene prefers to perpendicular adsorption on acidic surface, while the disubstituted benzenes prefer to horizontal adsorption, which decreases the adsorbed amounts. A photocatalytic rate mainly depends on electron donating property of the functional group and amount of adsorptive organic molecules, but not on electron density of benzene ring.

Fluid compensation in response to disappearance of the meaning of work

This study examined one's compensatory response to the sudden disappearance of the meaning of work. In a lab experiment, the unexpected termination of a preceding task was found to enhance one's labor supply in an irrelevant ensuing task, which provided direct support for one's pursuit of meaning and the fluid compensation strategy proposed by the Meaning Maintenance Model.

[Heterogeneous Oxidation of Secondary Organic Tracers of Isoprene and Toluene by Ozone]

For this paper, chamber experiments were carried out to investigate the oxidation of secondary organic tracers of toluene and isoprene by ozone under different conditions (relative humidity, mixing state, etc.) using a relative rate constants approach. The uncertainty of the tracer-based method due to the ozone oxidation of secondary organic tracers was also addressed. The results showed that the effective rate constants of analogue of 2-methyl erythritol (AME) and 2,3-dihydroxy-4-oxopentanoic acid (DHOPA) were (4.60±0.66)×10^-19 cm³·(molecule·s)^-1and (6.57±0.51)×10^-19 cm³·(molecule·s)^-1, respectively. Given the instability of the secondary organic tracers caused by the oxidation, the contributions of toluene and isoprene to secondary organic aerosols could be underestimated by 16.5%-44.8% and 18.3%-47.3%, respectively.

Airborne microbial communities in the atmospheric environment of urban hospitals in China

Clinically relevant antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) in bioaerosols have become a greater threat to public health. However, few reports have shown that ARB and ARGs were found in the atmosphere. High-throughput sequencing applied to environmental sciences has enhanced the exploration of microbial populations in atmospheric samples. Thus, five nosocomial bioaerosols were collected, and the dominant microbial and pathogenic microorganisms were identified by high-throughput sequencing in this study. The results suggested that the dominant microorganisms at the genus level were Massilia, Sphingomonas, Methylobacterium, Methylophilus, Micrococcineae, and Corynebacterineae. The most abundant pathogenic microorganisms were Staphylococcus saprophyticus, Corynebacterium minutissimum, Streptococcus pneumoniae, Escherichia coli, Arcobacter butzleri, Aeromonas veronii, Pseudomonas aeruginosa, and Bacillus cereus. The relationship between microbial communities and environmental factors was evaluated with canonical correspondence analysis (CCA). Meanwhile, differences in the pathogenic bacteria between bioaerosols and dust in a typical hospital was investigated. Furthermore, cultivable Staphylococcus isolates with multi-drug resistance phenotype (>3 antibiotics) in the inpatient departments were much higher than those in the transfusion area and out-patient departments, possibly attributed to the dense usage of antibiotics in inpatient departments. The results of this study might be helpful for scientifically air quality control in hospitals.

Value of two-cycle docetaxel, cisplatin, and 5-fluorouracil induction chemotherapy in hypopharyngeal carcinoma

Various studies have investigated laryngeal function and survival after induction chemotherapy in hypopharyngeal carcinoma, but potential factors to help predict response rates after induction chemotherapy remain unknown. This retro- spective study evaluated which factors are related to an ineffective response to two-cycle docetaxel, cisplatin, and 5-fluoro- uracil (TPF) induction chemotherapy in hypopharyngeal carcinoma to determine potential candidates for this treatment in clinical practice. From Jan 2005 to Dec 2015, 81 patients diagnosed with hypopharyngeal squamous cell carcinoma based on a pathological examination were analyzed. They were administered two-cycle TPF induction chemotherapy, and magnetic resonance imaging was performed before and after induction chemotherapy. The mean survival time was 5.7 years (95% confidence interval, 5.1-6.2 years). The 1, 3, 5 and 6-year survival rates were 98.8%, 80.1%, 64.5%, and 54.2%, respectively. TPF induction chemotherapy was well tolerated; the main adverse effects resolved with symptomatic treatment. A response to TPF induction chemotherapy was associated with lymph node size, tumor grade, invasion region, T stage, and primary tumor. The following issues were significantly associated with an increasing non-response rate to two-cycle induction chemotherapy: increasing lymph node size, moderately differentiated squamous cell carcinoma, invasion of the esophagus along with the thyroid cartilage, and primary tumor in the piriform sinus. Lymph nodes of ≥2.15 cm, moderately differenti- ated tumor grade, or thyroid cartilage invasion were the best cutoff values for patients who did not respond to induction chemotherapy. However, the initial cancer site, cancer stage, and degree of cancer differentiation were not closely related to the efficacy of induction chemotherapy.