Monitoring Of Function Research Articles

Global traumatic brain injury intracranial pressure: from monitoring to surgical decision.

Traumatic brain injury (TBI) is a significant global public health issue, heavily impacting human health, especially in low-and middle-income areas. Despite numerous guidelines and consensus statements, TBI fatality rates remain high. The pathogenesis of severe TBI is closely linked to rising intracranial pressure (ICP). Elevated intracranial pressure can lead to cerebral herniation, resulting in respiratory and circulatory collapse, and ultimately, death. Managing intracranial pressure (ICP) is crucial in neuro-intensive care. Timely diagnosis and precise treatment of elevated ICP are essential. ICP monitoring provides real-time insights into a patient's condition, offering invaluable guidance for comprehensive management. ICP monitoring and standardization can effectively reduce secondary nerve damage, lowering morbidity and mortality rates. Accurately assessing and using true ICP values to manage TBI patients still depends on doctors' clinical experience. This review discusses: (a) Epidemiological disparities of traumatic brain injuries across countries with different income levels worldwide; (b) The significance and function of ICP monitoring; (c) Current status and challenges of ICP monitoring; (d) The impact of decompressive craniectomy on reducing intracranial pressure; and (e) Management of TBI in diverse income countries. We suggest a thorough evaluation of ICP monitoring, head CT findings, and GCS scores before deciding on decompressive craniectomy. Personalized treatment should be emphasized to assess the need for surgical decompression in TBI patients, offering crucial insights for clinical decision-making.

Time course of electrical activity of the diaphragm (EAdi) in the peri extubation period and its role as predictor of extubation failure in difficult to wean patients

IntroductionWeaning patients from mechanical ventilation is crucial in the management of acute respiratory failure (ARF). Spontaneous breathing trials (SBT) are used to assess readiness for extubation, but extubation failure remains a challenge. Diaphragmatic function, measured by electrical activity of the diaphragm (EAdi), may provide insights into weaning outcomes.Materials and methodsThis prospective, observational study included difficult-to-wean patients undergoing invasive mechanical ventilation. EAdi was recorded before, during, and after extubation. Patients were categorized into extubation success and failure groups based on reintubation within 48 h. Statistical analysis assessed EAdi patterns and predictive value.ResultsThirty-one patients were analyzed, with six experiencing extubation failure. Overall, EAdi increased significantly between the phases before the SBT, the SBT and post-extubation period, up to 24 h (p < 0.001). EAdi values were higher in the extubation failure group during SBT (p = 0.01). An EAdi > 30 μV during SBT predicted extubation failure with 92% sensitivity and 67% specificity. Multivariable analysis confirmed EAdi as an independent predictor of extubation failure.ConclusionsIn difficult-to-wean patients, EAdi increases significantly between the phases before the SBT, the SBT and post-extubation period and is significantly higher in patients experiencing extubation failure. An EAdi > 30 μV during SBT may enhance extubation failure prediction compared to conventional parameters. Advanced monitoring of diaphragmatic function could improve weaning outcomes in critical care settings.

Application of Echocardiography in Anaesthesia: From Preoperative Risk Assessment to Postoperative Care.

Echocardiography has carved out a fundamental niche in anaesthesiology, revolutionizing the monitoring and management of cardiac function during surgery. Clinical practice has changed from simple 2D and 3D echocardiography to more sophisticated applications such as incorporating artificial intelligence. Echocardiography provides detailed real-time information about cardiac anatomy and function, helping anaesthesiologists make better decisions regarding tailoring anesthetic interventions and optimizing patient outcomes. From optimizing hemodynamic management in patients with severe aortic stenosis to fine-tuning fluid and vasopressor therapy in patients with right heart dysfunction, echocardiography has improved the care provided in the perioperative period. These applications permit the demonstration of not only technical advantages that could accrue from echocardiography but are also a part of individualized care to improve the outcomes of patients. The challenges in integrating echocardiography with anaesthesia include operator dependency, a steep learning curve in acquiring echocardiographic skills, and limitations due to patient factors and technological limitations, which lead to poor echocardiographic performance. Additionally, transoesophageal echocardiography (TEE) is an invasive procedure with several potential risks that must be considered cautiously. Continuing education, certification recommendations, and skill development are prerequisites for this echocardiography tool to remain robust and reliable in anaesthesiology. Technological innovation, especially in improving 3D imaging and integration with artificial intelligence, is where a very bright future lies ahead for echocardiography. It would further accelerate the process of echocardiographic evaluation and improve diagnostic accuracy. All these would turn out to be more person-centered for each patient. Anaesthesiologists must, therefore, pace themselves with such developments so these can be appropriately applied in the clinics. In summary, echocardiography became so integrally ingrained into anaesthesia that it propelled the specialty with essential tools anaesthesiologists use to manage patients for optimum outcomes. Its application has difficulties and limitations, but continued professional development and development of echocardiographic technology will make sure that its benefits are maximized. Quickly, echocardiography is becoming central to anaesthesiology's role in optimizing patient care and surgical success as we move into the application of evermore sophisticated echocardiographic techniques.

Material Composition and Implantation Site Affect in vivo Device Degradation Rate.

Successful tissue engineering requires biomedical devices that initially stabilize wounds, then degrade as tissue is regenerated. However, the material degradation rates reported in literature are often conflicting. Incorporation of in situ monitoring functionality into implanted devices would allow real time assessment of degradation and potential failure. This necessitates introduction of contrast agent as most biomedical devices are composed of polymeric materials with no inherent contrast in medical imaging modalities. In the present study, computed tomography (CT)-visible radiopaque composites were created by adding 5-20wt% tantalum oxide (TaO x ) nanoparticles into polymers with distinct degradation profiles: polycaprolactone (PCL), poly(lactide-co-glycolide) (PLGA) 85:15 and PLGA 50:50, representing slow, medium and fast degrading materials respectively. Radiopaque phantoms, mimicking porous tissue engineering devices, were implanted into mice intramuscularly or intraperitoneally, and monitored via CT over 20 weeks. Changes in phantom volume, including collapse and swelling, were visualized over time. Phantom degradation profile was determined by polymer matrix, regardless of nanoparticle addition and foreign body response was dictated by the implant site. In addition, degradation kinetics were significantly affected in mid-degrading materials, transitioning from linear degradation intramuscularly to exponential degradation intraperitoneally, due to differences in inflammatory responses and fluid flow. Nanoparticle excretion from degraded phantoms lagged behind polymer, and future studies will modulate nanoparticle clearance. Utilizing in situ monitoring, this study seeks to unify literature and facilitate better tissue engineering devices, by highlighting the relative effect of composition and implant site on important materials properties.

Neuromonitoring in the ICU: noninvasive and invasive modalities for critically ill children and neonates

Purpose of review Critically ill children are at risk of neurologic dysfunction and acquiring primary and secondary brain injury. Close monitoring of cerebral function is crucial to prevent, detect, and treat these complications. Recent findings A variety of neuromonitoring modalities are currently used in pediatric and neonatal ICUs. These include noninvasive modalities, such as electroencephalography, transcranial Doppler, and near-infrared spectroscopy, as well as invasive methods including intracranial pressure monitoring, brain tissue oxygen measurement, and cerebral microdialysis. Each modality offers unique insights into neurologic function, cerebral circulation, or metabolism to support individualized neurologic care based on a patient's own physiology. Utilization of these modalities in ICUs results in reduced neurologic injury and mortality and improved neurodevelopmental outcomes. Summary Monitoring of neurologic function can significantly improve care of critically ill children. Additional research is needed to establish normative values in pediatric patients and to standardize the use of these modalities.

Ownership concentration and SME IPO underpricing in India – moderating impact of board monitoring and resource provision role

PurposeThe study aims to explore how the monitoring and resource provision function of board of directors impact the association between ownership concentration and small- and medium-sized enterprise (SME) initial public offering (IPO) underpricing in the context of an emerging economy like India.Design/methodology/approachThe sample comprises 390 SME IPOs listed on Bombay Stock Exchange SME platform and National Stock Exchange EMERGE (EMERGE is the NSE new initiative for SMEs to raise the funds from investors) in India. To test the moderating impact of the board monitoring role and resource provision role, the study employs hierarchical moderated regression subject to the fulfillment of assumptions.FindingsThe findings divulge that ownership concentration significantly reduces underpricing, hinting towards the operationalization of alignment of interest hypothesis. With regards to moderating relationship, the study found that while board resource providing role negatively moderates the relationship between ownership concentration and SME IPO underpricing, board monitoring function fails to cast any significant impact on the relationship between ownership concentration and SME IPO underpricing.Research limitations/implicationsThe present study ignores larger firms listed on the main platform which have complex decision-making than smaller firms. Besides, it is confined to only a single country, i.e. India. Extending the study to other countries with similar institutional characteristics would have validated the findings. Furthermore, the moderating impact of other organizational factors like firm age, lifecycle of firm and change in technology would form an interesting avenue for future research.Practical implicationsThe findings of the study have practical implications for managers in designing the adequate board structure that significantly reduces underpricing. It thus further advices the issuers on focusing more on strengthening the resource provision role of board of directors for achieving higher rewards. The findings are helpful to policymakers in framing such policies that enhance the resource-oriented role of board of directors and resource accessibility for SMEs. Furthermore, the results advise the investors to be relatively assured about the SMEs whose board exercises its resource provision role emphatically. Accordingly, findings are helpful to investors in making investment decisions in alternative market settings characterized by the concentrated ownership structure.Originality/valueThe study furthers the debate on the importance of two prominent roles played by board as a moderating variable in the underexplored context of IPO underpricing of small and medium-sized firms in India.

Evaluation of Left Ventricular Remodeling and Prognosis after PCI in Acute Myocardial Infarction Using Real-Time, Three-Dimensional Echocardiography Combined with Layer-Specific Strain Imaging

Aim: This study aimed to evaluate left atrial and left ventricular volumes, strains, and strain rates in patients with acute ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI) using real-time three-dimensional echocardiography and layer-specific strain techniques. The relationships between these parameters and left ventricular remodeling (LVR) and prognosis were also explored. Methods: The study included 217 patients with first-episode STEMI who underwent emergency PCI. Echocardiography and myocardial strain analyses were performed within 24 h post-PCI. Patients were categorized into early and non-early LVR groups based on the increase in left ventricular end-diastolic volume (LVEDV). The occurrence of major cardiovascular adverse events (MACE) was followed up for one-year post-PCI. Differences in clinical data and ultrasound parameters between the groups were compared, and the predictive value of myocardial strain indicators for late LVR was analyzed using a multivariate logistic regression model and receiver operating characteristic (ROC) curves. Results: Early LVR occurred in 54.8% of patients and was characterized by decreased left ventricular systolic function, more segments with abnormal movement, and reduced absolute strain values in the three layers of the left ventricular wall myocardium, with a compensatory increase in left atrial strain rate during the contraction phase. The early LVR group showed a higher incidence of MACE at the one-year follow-up. At 6 months post-PCI, 29.9% of patients developed late LVR, which was not completely related to early LVR. Late LVR was associated with a higher incidence of MACE. The longitudinal strain value of each layer of left ventricular myocardium obtained from layer-specific strain imaging showed predictive value for advanced LVR. Conclusions: More than half of patients with STEMI develop early LVR post-PCI, with a higher incidence of MACE during one-year of follow-up, necessitating attention to early LVR in clinical practice. Late LVR, which develops in some patients after 6 months, is also linked to a higher incidence of MACE. Accurate monitoring of the myocardial deformation function using layer-specific strain imaging is expected to become a reference indicator for clinical diagnosis and treatment. Monitoring the structure and function of the left atrium and mitral valve alongside the LVR is important for prognostic assessment and for formulating diagnostic and treatment plans.

Incidence, characteristics, and risk factors of hypofibrinogenemia induced by generic tigecycline: a retrospective study.

The objective of this study was to evaluate the incidence, clinical features, and risk factors of generic tigecycline-associated hypofibrinogenemia. A single-center retrospective study was conducted in adult patients treated with generic tigecycline. Clinical data were extracted from the electronic medical records. The endpoint was tigecycline-related hypofibrinogenemia, defined as a condition with no abnormality in fibrinogen before tigecycline application, but developing hypofibrinogenemia upon prescription. The risk factors were determined by logistic regression analysis, and the ROC curve was subsequently established. A total of 240 adults prescribed generic tigecycline from May 1st to November 30th 2023 were included. It was shown that hypofibrinogenemia is a frequent side effect of generic tigecycline, with an adverse reaction rate of 42.9% (103/240). However, the incidence of adverse reactions to generic drugs was lower than in previous studies. The cumulative dose of tigecycline (OR:1.002, 95%CI 1.001-1.002, P < 0.001), baseline FIB (OR:0.995, 95%CI 0.992-0.997, P < 0.001), baseline PT (OR:1.247, 95%CI 1.071-1.452, P = 0.004) and baseline ALB (OR:0.931, 95%CI 0.879-0.986, P = 0.025) were identified as independent prognostic factors of tigecycline-related hypofibrinogenemia. We recommend intensive monitoring of coagulation function in patients exhibiting the aforementioned risk factors for generic tigecycline-associated hypofibrinogenemia to ensure patients safety.

Minimally invasive technique facilitates early extubation after cardiac surgery: a single-center retrospective study

BackgroundPostoperative time to extubation plays a role in prognosis after heart valve surgery; however, its exact impact has not been clarified. This study compared the postoperative outcomes of minimally invasive surgery and conventional sternotomy, focusing on early extubation and factors influencing prolonged mechanical ventilation.MethodsData from 744 patients who underwent heart valve surgery at the Zhejiang Provincial People’s Hospital between August 2019 and June 2022 were retrospectively analyzed. The outcomes in patients who underwent conventional median sternotomy (MS) and minimally invasive (MI) video-assisted thoracoscopic surgery were compared using inverse probability of treatment weighting (IPTW) and Kaplan–Meier curves. Clinical data, including surgical data, postoperative cardiac function, postoperative complications, and intensive care monitoring data, were analyzed.ResultsAfter propensity score matching and IPTW, 196 cases of conventional MS were compared with 196 cases of MI video-assisted thoracoscopic surgery. Compared to patients in the conventional MS group, those in the MI video-assisted thoracoscopic surgery group in the matched cohort had a higher early postoperative extubation rate (P < 0.01), reduced incidence of postoperative pleural effusion (P < 0.05), significantly shorter length of stay in the intensive care unit (P < 0.01), shorter overall length of hospital stay (P < 0.01), and lower total cost of hospitalization (P < 0.01).ConclusionsSuccessful early tracheal extubation is important for the intensive care management of patients after heart valve surgery. The advantages of MI video-assisted thoracoscopic surgery over conventional MS include significant reductions in the duration of use of mechanical ventilation support, reduced length of intensive care unit stay, reduced total length of hospitalization, and a favorable patient recovery rate.

Realistic Aspects of Cardiac Ultrasound in Rats: Practical Tips for Improved Examination.

Echocardiography is a reliable and non-invasive method for assessing cardiac structure and function in both clinical and experimental settings, offering valuable insights into disease progression and treatment efficacy. The successful application of echocardiography in murine models of disease has enabled the evaluation of disease severity, drug testing, and continuous monitoring of cardiac function in these animals. However, there is insufficient standardization of echocardiographic measurements for smaller animals. This article aims to address this gap by providing a guide and practical tips for the appropriate acquisition and analysis of echocardiographic parameters in adult rats, which may also be applicable in other small rodents used for scientific purposes, like mice. With advancements in technology, such as ultrahigh-frequency ultrasonic transducers, echocardiography has become a highly sophisticated imaging modality, offering high temporal and spatial resolution imaging, thereby allowing for real-time monitoring of cardiac function throughout the lifespan of small animals. Moreover, it allows the assessment of cardiac complications associated with aging, cancer, diabetes, and obesity, as well as the monitoring of cardiotoxicity induced by therapeutic interventions in preclinical models, providing important information for translational research. Finally, this paper discusses the future directions of cardiac preclinical ultrasound, highlighting the need for continued standardization to advance research and improve clinical outcomes to facilitate early disease detection and the translation of findings into clinical practice.

Liver-related aspects of valoctocogene roxaparvovec gene therapy for hemophilia A: expert guidance for clinical practice

AbstractAdeno-associated virus–based gene therapy (valoctocogene roxaparvovec) is an attractive treatment for hemophilia A. Careful clinical management is required to minimize the risk of hepatotoxicity, including assessment of baseline liver condition to determine treatment eligibility and monitoring liver function after gene therapy. This article describes recommendations (developed by a group of hemophilia experts) on hepatic function monitoring before and after gene therapy. To prevent harmful liver-related effects, gene therapy is contraindicated in patients with uncontrolled liver infections, autoimmune hepatitis, liver stiffness ≥8 kPa, or cirrhosis. Before using gene therapy in patients with liver steatosis or other liver disorders, the risk of liver damage should be considered using a highly individualized approach. Treatment is not recommended in patients with abnormal liver enzymes, including alanine aminotransferase (ALT) at any level above the upper limit of normal (ULN). Therefore, pretreatment assessment of liver health should include laboratory tests, abdominal ultrasound, and liver stiffness measurements by transient elastography (TE). In the first year after therapy, ALT levels should be monitored 1 to 2 times per week to detect elevations ≥1.5× ULN, which may require immunosuppressant therapy. Patients with ALT elevation should receive prednisone 60 mg/d for 2 weeks, followed by stepwise tapering when ALT returns to baseline. ALT monitoring should continue long term (every 3-6 months), along with abdominal ultrasound (every 6 months) and TE (yearly) evaluations. When patients with good liver health are selected for treatment and closely monitored thereafter, ALT elevations can be promptly treated and are expected to resolve without long-term hepatic sequelae.

Tirzepatide-Related Acute Liver Injury.

Tirzepatide should be used cautiously, with regular monitoring of liver function tests.If patients develop severe gastrointestinal symptoms or worsening abdominal pain, immediate hospital admission is necessary for further work-up, including a CT abdomen.Daily liver function tests, renal function tests and international normalised ratio (INR) tests should be conducted to identify and manage potential complications.

The correlation between the thyroid function and urinary iodine/creatinine ratio of pregnant women attending a tertiary hospital in Beijing, China, during different trimesters

ObjectiveThis study investigated the correlation between thyroid function and urinary iodine/creatinine ratio (UI/Cr) in pregnant women during different trimesters and explored potential influencing factors.MethodsIn this cross-sectional study, serum levels of thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), and UI/Cr were measured in 450 pregnant women. Correlations were analyzed using Pearson’s correlation coefficient and multiple linear regression. Subgroup analyses were performed based on age, body mass index (BMI), parity, gestational age, education, occupation, and family history of thyroid disorders.ResultsUI/Cr was positively correlated with FT4 levels in the first and second trimesters, particularly in women with older age, higher BMI, multiparity, higher education, and employment. No significant correlations were found between UI/Cr and TSH or FT3 levels.ConclusionUI/Cr is positively correlated with FT4 levels in early pregnancy, especially in women with certain risk factors. Regular monitoring of iodine status and thyroid function is recommended for pregnant women to ensure optimal maternal and fetal health.

Subclinical Hypothyroidism and Placenta Abruption: A Dangerous Relationship During Pregnancy

This case report explores the intricate link between subclinical hypothyroidism and placenta abruption during pregnancy, emphasising the potential risks and clinical implications, through a detailed case study of a 28-year-old woman with a history of hyperthyroidism, non-compliance, and subsequent subclinical hypothyroidism, causing placenta abruption leading to intrauterine death. The report highlights the challenges in managing thyroid disorders during pregnancy. Limited Malaysian data on this association prompts a broader discussion of international findings, suggesting a correlation between subclinical hypothyroidism and adverse pregnancy outcomes. The study delves into potential mechanisms, including thyroid hormone impact on placental vascular function and the complexity added by autoimmune thyroiditis. Personalised treatments, thyroid function monitoring, and comprehensive antenatal care are emphasised for optimal pregnancy outcomes. This case underscores the need for increased awareness, proactive management, and preconception counselling to safeguard maternal and foetal well-being.

Monitoring of Architectural Monuments

The article presents the main provisions that it is advisable to follow when organizing and conducting monitoring during the operation of cultural heritage sites. It is noted that the existing regulatory documents do not take into account the specifics of monitoring during operation, but are mainly aimed at protecting the monument from neighboring construction.Criteria are proposed to control the technical condition of historical buildings. Among them is the rate of development of long-term precipitation, which is considered as an indicator of the intensity of natural and man-made impacts on the building.Among them is the rate of development of long-term precipitation, which is considered as an indicator of the intensity of natural and man-made impacts on the building. It is noted that for stone structures, critical masonry stretching deformations serve as an effective criterion for the preservation of historical buildings, since in calculating the interaction of structures and foundations they are the primary criterion for calculating the second group of limiting states. In relation to it, the criterion of absolute precipitation and relative difference of precipitation is secondary. It is shown that over time, for buildings built on weak water-saturated clay soils, an increase in the unevenness of precipitation occurs. Special attention is paid to taking into account the accumulated uneven precipitation of buildings of historical development. The article presents the most characteristic types of deformations of buildings, among which in St. Petersburg the bend is most common, which is due to the regularity of building and rebuilding sections of urban neighborhoods.Monitoring is also considered as a reliable means of diagnosing the technical condition of the monument. The monitoring function is considered as a means of controlling the limitations of the monument’s operability, which continues to be operated in conditions of limited operational technical condition.

Monitoring and Evaluation Function of BPKN RI regarding Consumer Protection Issue in Housing Sector

The National Consumer Protection Agency of the Republic of Indonesia (BPKN RI) is a bureaucratic body derived from the Ministry of Trade that focuses on handling consumer problems in Indonesia. The paper further examines what makes the housing sector have a high level of complaints at BPKN RI, what types of complaints are filed by consumers and how the form of monitoring and evaluation functions within the scope of BPKN RI in solving problems given by BPKN RI to consumers. This research uses a qualitative method by conducting direct interviews with staff of the Advocacy Division of BPKN RI. The findings obtained are that the monitoring and evaluation of BPKN RI is quite optimal, especially for problems in the housing sector. The number of incoming cases had shown a high number due to the pandemic situation. BPKN RI's evaluation function runs quite well with the achievement of BPKN RI's recommendations being able to become the main basis for the formation of PUPR Ministerial Regulations to protect consumer rights in Indonesia.

Synthesis and evaluation of a novel ternary quaternary ammonium salts-fluorescent template copolymer: Integrating flocculation, sterilization, and monitoring functions

Developing flocculants with sterilization and monitoring functions is of practical significance for optimizing water treatment agents. In this research, a fluorescent monomer, EtFl, with double bonds was synthesized and copolymerized with acrylamide (AM) and 3-(methacryloyloxy)propyltrimethylammonium chloride (MAPTAC) using a linear anionic template agent. This synthesis successfully produced a multifunctional template copolymer, TP(AM-MAP-EtFl), with flocculation, sterilization and monitoring capabilities. The fluorescence intensity of TP(AM-MAP-EtFl) was measured using a fluorescence spectrophotometer, demonstrating strong performance even with an EtFl monomer mass fraction as low as 0.5 wt‰, resulting in a fluorescence intensity value of 1000 a.u., suitable for analytical detection. In flocculation experiments with simulated wastewater containing E. coli, the introduction of the fluorescent monomer did not affect E. coli flocculation. When flocculation conditions are optimized, the OD600 readings of the clear liquid remaining after treating with TP(AM-MAP-EtFl#0.5) and TP(AM-MAP-EtFl#5) are 0.0297 and 0.0457, respectively, illustrating superior sterilization effects. Interestingly, SEM and 3D-EEM results confirmed TP(AM-MAP-EtFl)’s bactericidal effect on E. coli, with the introduction of the fluorescent monomer not affecting the sterilization capability of quaternary ammonium. This work integrates flocculation, sterilization and fluorescence properties to provide sterilization-type flocculants with monitoring capabilities, enabling accurate calculation of polymer concentration by detecting solution fluorescence intensity, thereby offering potential for online detection and automatic control of water treatment systems, demonstrating good applicability.

Canopy temperature dynamics are closely aligned with ecosystem water availability across a water- to energy-limited gradient

Canopy temperature (Tc) plays an important role in regulating the rates of mass and energy fluxes at the leaf surface. Better understanding of the relationship between Tc and water availability may enable more accurate monitoring of ecosystem functioning in a changing climate. Here, we used high spatiotemporal resolution thermal infrared cameras deployed at three eddy covariance flux tower sites along a water- to energy-limited gradient – including a predominately water-limited grassland/shrubland site, a seasonally water-limited evergreen needleleaf forest, and a predominantly energy-limited deciduous broadleaf forest – to determine Tc seasonality and its relationship with gross primary productivity (GPP) and environmental drivers. We found midday Tc was generally warmer than air temperature (Tair) during the growing season (Tc:Tair slope: 1.14–1.27) for all sites. Water-limited sites exhibited higher positive Tc deviations from Tair (2.30 ± 0.06 °C) compared to the energy-limited site (1.29 ± 0.09 °C) partly due to their reduced latent heat fluxes during water-limited periods. We further found that the Tc:Tair slope increased with site aridity, namely for 1.14 slope for the grassland, 1.15 for the evergreen forest, and 1.27 for the broadleaf forest. Peak GPP occurred when Tc was higher than Tair across all sites, with peak GPP at the grassland site occurring at +1.1 °C (Tc-Tair) and peak GPP at the broadleaf evergreen site occurring at +2.2 °C (Tc-Tair). Tc-Tair dynamics were mostly associated with soil water content at water-limited sites where canopies undergo a substantial cooling during the transition from dormancy to the peak GPP, while net radiation played a crucial role at the energy-limited site where the canopy heats up compared to Tair over the same phenological transition. Our findings provide novel insights into Tc-ecosystem water availability links, highlighting the drivers of Tc-Tair across diverse ecosystems in various phenological stages, which has implications for ecosystem management in a changing climate.

Iodinated Contrast Induced Hypothyroidism in the Infant After Enteral Contrast Enema: A Case Report and Systematic Review.

Excessive iodine intake triggers the Wolff-Chaikoff effect resulting in downregulation of thyroid hormone synthesis to prevent hyperthyroidism. Failure to escape the Wolff-Chaikoff effect can be seen especially in (premature born) infants and may result in prolonged iodine induced hypothyroidism. We describe a rare case of a preterm infant who developed severe iodinated contrast induced hypothyroidism after the use and prolonged stasis of enteral iodinated contrast media (ICM). In addition a systematic literature search was performed to evaluate all available data on this complication. A systematic literature search was performed in PubMed and Embase. Studies describing the effect of enteral ICM on thyroid function were considered eligible. The primary outcome was to determine the frequency of contrast induced hypothyroidism in infants after administration of enteral ICM. The premature infant in our center developed severe iodinated contrast induced hypothyroidism after enteral ICM. In total, only two studies met our eligibility data, reporting eight patients. Out of these eight patients, four premature infants developed a contrast induced hypothyroidism after enteral administration of ICM. Data on severity, length and frequency of contrast induced hypothyroidism after exposure to enteral ICM is very scarce. The herein reported case and literature search illustrate the potential severity of the complication and underline the necessity of future studies on this topic. We recommend standardized monitoring of thyroid function after exposure to enteral ICM in newborns to prevent delayed diagnosis of severe contrast induced hypothyroidism until evidence based recommendations can be made.

Research on jujube storage and preservation system based on Internet of Things (IoT)

With the surge in Xinjiang jujube production, there has been a concurrent increase in storage losses, posing an ongoing challenge for farmers to preserve the freshness of the jujubes. To tackle this issue, a novel storage and freshness control system for jujubes, integrating Internet of Things technology, has been developed. The control system is centered around a programmable logic controller (PLC) and utilizes an HMI as the interface for human–computer interaction. It is structured with distinct layers, including equipment, transportation, and application layers. By integrating with the Internet of Things cloud platform, data transmission between the device layer and the cloud server is ensured through the use of the TCP/IP protocol over a 4G network. A mobile app enables remote control functionality for monitoring and managing the storage and preservation environment. Experimental results demonstrate the system's stable performance, enabling remote monitoring and convenient operation by management personnel during the jujube storage and preservation process. This contributes to enhancing automation levels in jujube storage, extending its storage cycle while maintaining quality standards, thus providing valuable insights into intelligent fruit and vegetable storage practices in Xinjiang.