Intravascular photoacoustic and optical coherence tomography imaging dual-mode system for detecting spontaneous coronary artery dissection: A feasibility study

In this work,we present an intravascular dual-mode endoscopic system capable of both intravascular photoacoustic imaging(IVPAI)and intravascular optical coherence tomography(IVOCT)for recognizing spontaneous coronary artery dissection(SCAD)phantoms.IVPAI provides high-resolution and high-penetration images of intramural hematoma(IMH)at different depths,so it is especially useful for imaging deep blood clots associated with imaging phantoms.IVOCT can readily visualize the double-lumen morphology of blood vessel walls to identify intimal tears.We also demonstrate the capability of this dual-mode endoscopic system using mimicking phantoms and biological samples of blood clots in ex vivo porcine arteries.The results of the experiments indicate that the combined IVPAI and IVOCT technique has the potential to provide a more accurate SCAD assessment method for clinical applications.

Hydroxychloroquine: A Safe, Effective and Inexpensive Maintenance Therapy for Chronic Spontaneous Urticaria

Background: Chronic spontaneous urticaria (CSU) is an autoimmune skin disorder that lasts for >6 weeks and may last for years. It is a disabling skin disease that impairs quality of life. Set-up treatment with antihistamines, immunosuppressives, immune modulators and lately Omalizumab are expensive or have significant side effects. In this retrospective study, we describe our experience with the use of hydroxychloroquine (HCQ) as a maintenance therapy for those with severe forms of CSU after Corticosteroids (C) induction phase. Patients and Methods: 16 adult patients (aged 44 ± 7) with severe CSU for 5 ± 1 months, were included in the study. Eight patients had attacks of angioneurotic oedema. Their previous treatments were antihistaminic and short-courses of C. Results: After 2 weeks of remission with C and HCQ 200 mg twice daily, the dose of C was tapered down and discontinued by the end of the first month. The seven days Urticaria Activity Score decreased from 30 ± 3 to 6 ± 1 by the first month and remained low at 3 ± 1 by the end of 2 years of follow-up. Moreover, IgE levels and CRP had similar trends. Remission persisted after 37 ± 9 months of follow-up. Conclusion: HCQ is a safe, efficacious and inexpensive drug for the treatment of CSU.

Effect and Mechanism of Rare Earth Hydrotalcite Inhibiting Coal Spontaneous Combustion

A hydrotalcite(layered double hydroxide, LDH) inhibitor which is suitable for the whole process of coal spontaneous combustion and a LDH inhibitor containing rare earth lanthanum elements were prepared. The inhibition effect and mechanism were analyzed by scanning electron microscopy(SEM),X-ray diffraction(XRD), thermal performance analysis, in-situ diffuse reflectance infrared spectroscopy and temperature-programmed experiment. The results have shown that the inhibitor containing lanthanum can play a good inhibitory role in every stage of coal oxidation. During the slow oxidation of coal samples, the inhibitor containing lanthanum ions can slow down the oxidation process of coal and increase the initial temperature of coal spontaneous combustion. At the same time, because the hydroxyl groups in LDHs are connected with-COO-groups on the coal surface through hydrogen bonds, the stability of coal is improved. With the increase of temperature, LDHs can remove interlayer water molecules and reduce the surface temperature of coal. CO release rate of coal samples decreases significantly after adding inhibitor containing lanthanum element, and the maximum inhibition rate of the inhibitor is 58.1%.

Fractal model of spontaneous imbibition in low-permeability reservoirs coupled with heterogeneity of pore seepage channels and threshold pressure

Spontaneous imbibition(SI)is an important mechanism for enhancing oil recovery in low-permeability reservoirs.Due to the strong heterogeneity,and the non-Darcy flow,the construction of SI model for lowpermeability reservoirs is extremely challenging.Commonly,traditional SI models based on single or averaged capillary tortuosity ignore the influence of heterogeneity of pore seepage channels and the threshold pressure(TP)on imbibition.Therefore,in this work,based on capillary model and fractal theory,a mathematical model of characterizing SI considering heterogeneity of pore seepage channels is established.On this basis,the threshold pressure was introduced to determine the pore radius at which the wetted phase can displace oil.The proposed new SI model was verified by imbibition experimental data.The study shows that for weakly heterogeneous cores with permeability of 0-1 m D,the traditional SI model can characterize the imbibition process relatively accurately,and the new imbibition model can increase the coefficient of determination by 1.05 times.However,traditional model has serious deviations in predicting the imbibition recovery for cores with permeability of 10-50 m D.The new SI model coupling with heterogeneity of pore seepage channels and threshold pressure effectively solves this problem,and the determination coefficient is increased from 0.344 to 0.922,which is increased by2.68 times.For low-permeability reservoirs,the production of the oil in transitional pores(0.01-0.1μm)and mesopores(0.1-1μm)significantly affects the imbibition recovery,as the research shows that when the heterogeneity of pore seepage channels is ignored,the oil recovery in transitional pores and mesopores decreases by 7.54%and 4.26%,respectively.Sensitivity analysis shows that increasing interfacial tension,decreasing contact angle,oil-water viscosity ratio and threshold pressure will increase imbibition recovery.In addition,there are critical values for the influence of these factors on the imbibition recovery,which provides theoretical support for surfactant optimization.

Spontaneous Recovery in Directed Dynamical Networks

Complex networked systems,which range from biological systems in the natural world to infrastructure systems in the human-made world,can exhibit spontaneous recovery after a failure;for example,a brain may spontaneously return to normal after a seizure,and traffic flow can become smooth again after a jam.Previous studies on the spontaneous recovery of dynamical networks have been limited to undirected networks.However,most real-world networks are directed.To fill this gap,we build a model in which nodes may alternately fail and recover,and we develop a theoretical tool to analyze the recovery properties of directed dynamical networks.We find that the tool can accurately predict the final fraction of active nodes,and the prediction accuracy decreases as the fraction of bidirectional links in the network increases,which emphasizes the importance of directionality in network dynamics.Due to different initial states,directed dynamical networks may show alternative stable states under the same control parameter,exhibiting hysteresis behavior.In addition,for networks with finite sizes,the fraction of active nodes may jump back and forth between high and low states,mimicking repetitive failure-recovery processes.These findings could help clarify the system recovery mechanism and enable better design of networked systems with high resilience.

Underlying anti-hypertensive mechanism of the Mizuhopecten yessoensis derived peptide NCW in spontaneously hypertensive rats via widely targeted kidney metabolomics

The angiotensin-converting enzyme(ACE)inhibitory peptide NCW derived from Mizuhopecten yessoensis has been demonstrated to have significant in vivo anti-hypertensive effects,however,its anti-hypertensive mechanism is still not fully clarified.This study established a UPLC-Q-TRAP-MS/MS-based widely targeted kidney metabolomics approach to explore the changes of kidney metabolic profiles and to clarify the antihypertensive mechanism of peptide NCW in spontaneously hypertensive rats(SHRs).Multivariate statistical analysis indicated that the kidney metabolic profiles were clearly separated between the SHR-NCW and SHRUntreated groups.A total of 85 metabolites were differentially regulated,and 16 metabolites were identified as potential kidney biomarkers,e.g.,3-hydroxybutyrate,malonic acid,deoxycytidine,and L-aspartic acid.The peptide NCW might regulate kidney metabolic disorder of SHRs to alleviate hypertension by suppressing inflammation and improving nitric oxide production under the regulation of linoleic acid metabolism,folate related pathways,synthesis and degradation of ketone bodies,pyrimidine metabolism,β-alanine metabolism,and retinal metabolism.

Management of Spontaneous Intracerebral Haemorrhage (sICH) at the University Hospital of Brazzaville (CONGO)

Spontaneous intracerebral haemorrhage (sICH) is characterised by bleeding within the brain parenchyma, without any accompanying vascular malformation, parenchymal abnormality or coagulation disorder. The study aimed to depict the management of sICH at the University Hospital of Brazzaville (UHB). It was an observational, descriptive, and cross-sectional analysis. Data collection was conducted retrospectively, covering the period from January 1, 2020 to August 31, 2022, spanning two years and eight months. The study examined socio-demographic, diagnostic, therapeutic, and evolutionary variables. We included 274 cases. We observed 160 men (58.4%) and 114 women (41.6%), resulting in a sex ratio of 1.4. The mean age was 55.3 ± 11.4 years, with ages ranging from 31 to 93 years. The detection of sICH was typically a result of experiencing motor deficits (59.5%) or disorders of consciousness (37.2%). The weightiness of one half of the body was the most common reason for seeking medical advice. Hematoma was capsulo-lenticular in 159 cases (58%) and capsulo-thalamic in 63 cases (23%). Hematomas were <30 ml in 162 cases (59.1%) and >30 ml in 112 cases (40.9%), and associated with hydrocephalus in 11.7% of cases. Conservative medical treatment was administered in 257 cases (94.2%) while surgical treatment was performed in 16 cases (5.8%). The surgical techniques used were external ventricular drainage (EVD) in 2 cases, ventriculo-peritoneal shunt in 5 cases, and hematoma evacuation in 10 cases. Death occurred before the 7th day of hospitalisation in 73 cases (57.8%) and after in 46 cases (42.2%). The median time to death was four days (Q1 = 2 days;Q3 = 7 days), with extremes of 0 and 216 days. .

Evaluating the Efficacy of Cervical Tactile Ultrasound Technique as a Predictive Tool for Spontaneous Preterm Birth

Background: Premature cervical softening and shortening may be considered an early mechanical failure that predispose to preterm birth. Purpose: This study aims to explore the applicability of an innovative cervical tactile ultrasound approach for predicting spontaneous preterm birth (sPTB). Materials and Methods: Eligible participants were women with low-risk singleton pregnancies in their second trimester, enrolled in this prospective observational study. A Cervix Monitor (CM) device was designed with a vaginal probe comprising four tactile sensors and a single ultrasound transducer operating at 5 MHz. The probe enabled the application of controllable pressure to the external cervical surface, facilitating the acquisition of stress-strain data from both anterior and posterior cervical sectors. Gestational age at delivery was recorded and compared against cervical elasticity. Results: CM examination data were analyzed for 127 women at 240/7 - 286/7 gestational weeks. sPTB was observed in 6.3% of the cases. The preterm group exhibited a lower average cervical stress-to-strain ratio (elasticity) of 0.70 ± 0.26 kPa/mm compared to the term group’s 1.63 ± 0.65 kPa/mm with a p-value of 1.1 × 10−4. Diagnostic accuracy for predicting spontaneous preterm birth based solely on cervical elasticity data was found to be 95.0% (95% CI, 88.5 - 100.0). Conclusion: These findings suggest that measuring cervical elasticity with the designed tactile ultrasound probe has the potential to predict spontaneous preterm birth in a cost-effective manner.

Spontaneous Paravesical and Broad Ligament Hematoma after Vaginal Delivery Had Uterine Artery Embolization after Evacuating the Hematoma

Broad ligament hematoma is typically seen during cesarean section due to rupture of branches of uterine and vaginal vessels and it’s rare to be seen post-normal vaginal delivery. Addressing puerperal hematomas postpartum presents considerable challenges for obstetric care providers. While hematomas such as those affecting the vulva, vulvovaginal region, or paravaginal area are frequently encountered, retroperitoneal hematomas are rare and notably pose a greater risk to the life of the patient. The medical literature contains scant case reports on retroperitoneal hematomas, with no consensus on a definitive treatment approach. Pelvic arterial embolization has emerged as both a sensible and increasingly preferred method for treating these hematomas recently, but its application is contingent upon the patient maintaining hemodynamic stability and the availability of a specialized interventional embolization unit. In our case, we are presenting a very rare case of a 31-year-old primigravida female with a history of in vitro fertilization pregnancy. She delivered a normal vaginal delivery at 31 weeks gestation. Unfortunately, she experienced multiple complications intrapartum, including preeclampsia and placental abruption. These complications increased her risk of developing a broad ligament hematoma.

The effects of various factors on spontaneous imbibition in tight oil reservoirs

Slickwater fracturing fluids have gained widespread application in the development of tight oil reservoirs. After the fracturing process, the active components present in slickwater can directly induce spontaneous imbibition within the reservoir. Several variables influence the eventual recovery rate within this procedure, including slickwater composition, formation temperature, degree of reservoir fracture development, and the reservoir characteristics. Nonetheless, the underlying mechanisms governing these influences remain relatively understudied. In this investigation, using the Chang-7 block of the Changqing Oilfield as the study site, we employ EM-30 slickwater fracturing fluid to explore the effects of the drag-reducing agent concentration, imbibition temperature, core permeability, and core fracture development on spontaneous imbibition. An elevated drag-reducing agent concentration is observed to diminish the degree of medium and small pore utilization. Furthermore, higher temperatures and an augmented permeability enhance the fluid flow properties, thereby contributing to an increased utilization rate across all pore sizes. Reduced fracture development results in a lower fluid utilization across diverse pore types. This study deepens our understanding of the pivotal factors affecting spontaneous imbibition in tight reservoirs following fracturing. The findings act as theoretical, technical, and scientific foundations for optimizing fracturing strategies in tight oil reservoir transformations.

Spontaneous coronary artery rupture after lung cancer surgery:A case report and review of literature

BACKGROUND Spontaneous coronary artery rupture(SCAR)is a rare and life-threatening complication after lung cancer surgery.We present a case of SCAR following left upper lobectomy,successfully managed through emergency thoracotomy and coronary artery ligation.CASE SUMMARY A 61-year-old male patient underwent left upper lobectomy and mediastinal lymph node dissection for lung cancer.The surgery was performed using singleport video-assisted thoracoscopic surgery,and there were no observed complications during the procedure.However,19 h after surgery,the patient experienced chest discomfort and subsequently developed severe symptoms,including nausea,vomiting,and a drop in blood pressure.Urgent measures were taken,leading to the diagnosis of SCAR.The patient underwent emergency thoracotomy and coronary artery ligation,successfully stopping the bleeding and stabilizing the condition.Despite postoperative complications,the patient made a successful recovery and was discharged from the hospital.CONCLUSION SCAR is a rare but life-threatening complication following lung cancer surgery.Immediate thoracotomy has been shown to be a life-saving measure,while stenting is not the preferred initial approach.

A novel predictor of unsustained return of spontaneous circulation in cardiac arrest patients through a combination of capnography and pulse oximetry: a multicenter observational study

BACKGROUND:Unsustained return of spontaneous circulation(ROSC)is a critical barrier to survival in cardiac arrest patients.This study examined whether end-tidal carbon dioxide(ETCO_(2))and pulse oximetry photoplethysmogram(POP)parameters can be used to identify unsustained ROSC.METHODS:We conducted a multicenter observational prospective cohort study of consecutive patients with cardiac arrest from 2013 to 2014.Patients’general information,ETCO_(2),and POP parameters were collected and statistically analyzed.RESULTS:The included 105 ROSC episodes(from 80 cardiac arrest patients)comprised 51 sustained ROSC episodes and 54 unsustained ROSC episodes.The 24-hour survival rate was significantly higher in the sustained ROSC group than in the unsustained ROSC group(29.2%vs.9.4%,P<0.05).The logistic regression analysis showed that the difference between after and before ROSC in ETCO_(2)(ΔETCO_(2))and the difference between after and before ROCS in area under the curve of POP(ΔAUCp)were independently associated with sustained ROSC(odds ratio[OR]=0.931,95%confi dence interval[95%CI]0.881-0.984,P=0.011 and OR=0.998,95%CI 0.997-0.999,P<0.001).The area under the receiver operating characteristic curve ofΔETCO_(2),ΔAUCp,and the combination of both to predict unsustained ROSC were 0.752(95%CI 0.660-0.844),0.883(95%CI 0.818-0.948),and 0.902(95%CI 0.842-0.962),respectively.CONCLUSION:Patients with unsustained ROSC have a poor prognosis.The combination ofΔETCO_(2) andΔAUCp showed signifi cant predictive value for unsustained ROSC.

Correction:Establishment of a prediction model for prehospital return of spontaneous circulation in out-of-hospital patients with cardiac arrest

This is an erratum to an already published paper named“Establishment of a prediction model for prehospital return of spontaneous circulation in out-ofhospital patients with cardiac arrest”.We found errors in the affiliated institution of the authors.We apologize for our unintentional mistake.Please note,these changes do not affect our results.

Multi-modal imaging for the diagnosis of spontaneous visceral artery dissection:A case report

BACKGROUND Spontaneous visceral artery dissection(SVAD)is a rare condition that affects the visceral arteries,such as the celiac,superior mesenteric,and inferior mesenteric arteries,without involving the aorta.Organ ischemia or hemorrhage from vessel rupture can occur in SVAD;therefore,prompt detection and management is essential.Contrast-enhanced computed tomography(CECT)has been used to diagnose most of the previous cases,but few studies have explored the potential of contrast-enhanced ultrasound(CEUS)for early detection of this disease.CASE SUMMARY A 53-year-old male presented with complaints of poor appetite and abnormal liver function for the past 6 months.He had previously undergone transabdominal splenectomy,esophagogastric devascularization,and cholecystectomy for gallstones and severe portal hypertension.Liver ultrasound was performed in our department to assess liver status.An abnormal hepatic artery spectrum was observed,and dissection involving both the celiac artery and the common hepatic artery was observed.A CEUS was then performed and clearly showed the entry site of the intimal tear and the false lumen,and dissection was subsequently confirmed by CECT.The patient was asymptomatic;therefore,treatment to control the blood pressure was provided,and follow-up was recommended.After 6 months of follow-up,the celiac artery was found to be dilated with an adherent thrombus visible in the wall,and the common hepatic artery was occluded with the presence of collateralization.Despite these findings,no significant changes in liver function were observed.CONCLUSION Multi-modal imaging is effective in diagnosing SVAD,and conservative treatment is a choice for asymptomatic patients.

Spontaneous Tumor Lysis Syndrome Secondary to Iatrogenic Acute Kidney Injury: A Case Report

Spontaneous Tumor Lysis Syndrome (STLS) is a rare oncologic condition caused by the breakdown of neoplastic tissue in the absence of traditional anti-tumor therapy. It is postulated that cancers with rapidly dividing cells lead to increased cell turnover which exceeds the kidneys’ ability to adequately filtrate by-products of cellular breakdown (i.e., phosphate, potassium, anduric acid), leading to end organ damage. It has been reported in the past that kidney failure is a sequelae of Tumor Lysis Syndrome (TLS), but there have been no reports that demonstrate acute kidney injury (AKI) preceding TLS. The case presented here demonstrates TLS in a patient with no formal cancer diagnosis, who had received no chemotherapy or radiation that was precipitated by an iatrogenic AKI with chlorthalidone and ibuprofen. This unusual pattern of AKI preceding STLS may provide insight into the pathophysiology of the condition and could possibly lead to greater understanding of this phenomenon.

Populational change of CD4^(+)CD25^(+)Treg cells is responsible for the synergistic effect of the combination of RAMP2 with baicalin in treating recurrent spontaneous abortion mouse models

Background: The absence of a safe and effective therapy for recurrent spontaneous abortion due to a maternofetal failure in immunological tolerance remains an intractable clinical obstacle for surgeons. Recently, traditional Chinese medicine has become a feasible alternative for certain diseases, including recurrent spontaneous abortion. However, because of the complex composition of the traditional Chinese medicine formula, its action mechanism remains unclear. Methods: We selected two isolated active ingredients (RAMP and baicalin) from the traditional Chinese medicine formula and used an abortion-prone CBA/J × DBA/2 model to simulate human RSA and compared the changes in fetal resorption rate, Treg cell percentage, and relevant cytokines before and after combination therapy. In addition, The mechanisms were preliminarily discussed using in vitro differentiation models. Results: In CBA/J × DBA/2 abortion-prone mice, the combination therapy resulted in a lower embryo resorption rate compared to that obtained with individual delivery of either RAMP or baicalin, thereby playing an embryo-protective role through the increase in Treg cells for the maintenance of maternal-fetal immune tolerance. In in vitro primary cell differentiation experiments, the concentration of Treg cells significantly increased from 11% to 17.9% after the combination therapy compared to that of the single administration group. Conclusion: the synergistic effects of RAMP and baicalin were responsible for Treg differentiation. The present study provides a solid basis for improving the applicability of traditional Chinese herbs in the treatment of recurrent spontaneous abortion.

Establishment of a prediction model for prehospital return of spontaneous circulation in out-of-hospital patients with cardiac arrest

BACKGROUND Out-of-hospital cardiac arrest(OHCA)is a leading cause of death worldwide.AIM To explore factors influencing prehospital return of spontaneous circulation(P-ROSC)in patients with OHCA and develop a nomogram prediction model.METHODS Clinical data of patients with OHCA in Shenzhen,China,from January 2012 to December 2019 were retrospectively analyzed.Least absolute shrinkage and selection operator(LASSO)regression and multivariate logistic regression were applied to select the optimal factors predicting P-ROSC in patients with OHCA.A nomogram prediction model was established based on these influencing factors.Discrimination and calibration were assessed using receiver operating charac-teristic(ROC)and calibration curves.Decision curve analysis(DCA)was used to evaluate the model’s clinical utility.RESULTS Among the included 2685 patients with OHCA,the P-ROSC incidence was 5.8%.LASSO and multivariate logistic regression analyses showed that age,bystander cardiopulmonary resuscitation(CPR),initial rhythm,CPR duration,ventilation mode,and pathogenesis were independent factors influencing P-ROSC in these patients.The area under the ROC was 0.963.The calibration plot demonstrated that the predicted P-ROSC model was concordant with the actual P-ROSC.The good clinical usability of the prediction model was confirmed using DCA.CONCLUSION The nomogram prediction model could effectively predict the probability of P-ROSC in patients with OHCA.

Spontaneous Pneumothorax Complicating Miliary Tuberculosis: About a Case at the “Centre Medical Principal De La Gendarmerie Nationale Du Mali”

Introduction: Spontaneous pneumothorax is a rare but serious complication of tuberculosis. Miliary tuberculosis (MT) is a severe form of tuberculosis secondary to hematogenous spread of Mycobacterium tuberculosis. Objective: To report a case of MT complicated by pneumothorax. Methodology: This was a 25-year-old patient, farmer, followed up at the Pneumo-phtisiology department of the CHU du Point G for MT whose condition was improving after the introduction of anti-tuberculosis chemotherapy. He consulted again after experiencing chest pain. Clinical and imaging revealed a Spontaneous pneumothorax complicating MT. The treatment combined anti-tuberculosis chemotherapy, chest drainage and respiratory physiotherapy. Outcome was favorable with improvement of clinical and radiological signs. Conclusion: Pneumothorax complicating MT requires a reflective diagnostic approach and rapid management to improve its prognosis.

Spontaneous fracture of a titanium mesh cranioplasty implant in a child: A case report

BACKGROUND Titanium mesh cranioplasty is often performed after decompressive craniectomy.Spontaneous fracture of the titanium prosthesis is an extremely rare postoperative complication.Here,we report a 10-year-old boy who presented with a spontaneous fracture of titanium mesh without antecedent head trauma.CASE SUMMARY A 10-year-old boy presented with a 1-wk history of a tender bulge over the left temporo-parieto-occipital scalp.He had undergone a temporo-parieto-occipital titanium mesh cranioplasty 26 mo previously.He denied antecedent head trauma.Computerized tomography disclosed a perpendicular fissure in the titanium mesh,suggesting a diagnosis of spontaneous titanium mesh fracture.He underwent a second temporo-parieto-occipital cranioplasty and made an uneventful recovery.Three-dimensional modeling and finite element analyses were used to explore potential risk factors of titanium mesh fracture.CONCLUSION We report a case of spontaneous fracture of a titanium mesh cranioplasty implant.The current case and literature review indicate that titanium mesh implants should be well-anchored to the base of bony defects to prevent fatigue-induced fractures.

Spontaneous emission fromΛ-type three-level atom driven by bichromatic field in anisotropic double-band photonic crystals

The spontaneous emission property ofΛ-type three-level atom driven by the bichromatic field in the anisotropic double-band photonic crystal is calculated by n-times iteration method.The influence of different parameters on atomic spontaneous emission is studied,and the phenomena of atomic spontaneous emission are explained in the dressed state representation.It is found that the spontaneous emission spectra of the atom driven by the bichromatic field presents a multi-peak comb structure.The position of the emission peak is determined by the initial state of the atom,and the interval between the neighboring emission peaks is the detuningδof the bichromatic field.When the ratio between Rabi frequency intensity and the detuningδof the bichromatic field remains unchanged,the intensity of each emitted peak remains invariant.The spontaneously emitted peak can be annihilated in the band gap and enhanced near the band edge in the anisotropic photonic crystals.Meanwhile,we also observe the fluorescence quenching phenomenon in the spontaneous emission spectra.The research in this paper provides the theoretical guidance for the control of atomic spontaneous emission.