Response Threshold Research Articles

Effect of Genetic Polymorphisms of ABCB1, ABCG2, and SLC22A1 on the Steady-State Plasma Concentrations of Lamotrigine in Treatment-Resistant Depressed Patients Treated With Lamotrigine Augmentation Therapy.

The authors have demonstrated that a plasma lamotrigine concentration of 12.7 μmol/L may be a threshold for a good therapeutic response to lamotrigine augmentation therapy in treatment-resistant depressed patients. Lamotrigine is a substrate of P-glycoprotein, breast cancer resistant protein and organic cation transporter 1, which are encoded by ABCB1 , ABCG2 , and SLC22A1 , respectively. There have been several polymorphisms that affect its function. The present study investigated the relationship between these polymorphisms and the steady-state plasma concentrations (Css) of lamotrigine in treatment-resistant depressed patients receiving lamotrigine as augmentation therapy. One hundred twenty-nine treatment-resistant depressed patients were included in this study. Treatment resistance is defined as lack of therapeutic response to at least 3 psychotropics despite adequate doses and duration. Their diagnoses were as follows: major depressive disorder (n = 58), bipolar II disorder (n = 52), and bipolar I disorder (n = 19). Lamotrigine augmentation therapy for 8 weeks was conducted. The final lamotrigine doses were 75 mg/d for 39 patients with valproate and 100 mg/d for 90 without it. Blood was sampled at 8:00 am after the 8th week of treatment. Plasma lamotrigine levels were quantified by using LC/MS/MS. The polymorphisms of ABCB1 1236C>T, 2677G>T/A, 3435C>T, ABCG2 421C>A, and SLC22A1 1222G>A were detected by polymerase chain reaction analyses. No significant relationships were observed between these polymorphisms and the Css of lamotrigine in the patients with or without valproate. The present study suggests that these genetic polymorphisms do not play a role in controlling the Css of lamotrigine in treatment-resistant depressed patients treated with lamotrigine augmentation therapy.

MOF-derived Mo-doped Co3O4: A hierarchical yeast-like structure for superior carbon monoxide sensing

Carbon monoxide (CO) is one of the most dangerous gases owing to its dual threat, role in global warming, and severe impact on human health. Metal-organic framework (MOF) gas-sensing materials have drawn the interest of many different sectors due to their unique structural characteristics. This study used a solvothermal technique and subsequent annealing to create a hierarchical, yeast-shaped Mo-Co3O4 material from a Co-MOF precursor. The prepared materials have been employed in the development of a CO-detection gas sensor. Gas-sensing experiments revealed that Mo-Co3O4 exhibited significantly improved sensing capabilities compared to pure Co3O4. Notably, at 200 °C, 2 mol% Mo-Co3O4 showed high response levels of about 136 at 100 ppm CO concentrations, approximately 50.4 times higher than pure Co3O4. Furthermore, the Mo-doped material exhibited a low detection threshold, excellent reproducibility, long-term stability, good selectivity, and rapid response and recovery times (78.5/55.3 s). Introducing Mo dopants into the Co3O4 material and the hierarchical yeast-like nanostructure are responsible for these improvements in gas-sensing capability.

THE USE OF NERVE MONITORIZATION IN PAROTID, SUBMANDIBULAR GLAND AND FACIAL SURGERY AND ITS EFFECT ON PROGNOSIS

Objective: The facial nerve and its branches are at risk during facial surgery. The surgery with the highest risk is parotid and submandibular gland surgery. An attempt was made to determine threshold values in terms of paralysis in nerve monitoring parameters. These determined values could not be used to predict facial nerve function after surgery. The aim of this study is to investigate the relationship between the parameters detected by nerve stimulation during surgery and postoperative facial nerve dysfunction in patients who underwent parotid and submandibular gland surgery. Material and Methods: A total of 29 facial nerve branches of 13 patients who underwent superficial parotidectomy or submandibular gland resection were examined. Patients were examined in two groups: those who did not develop paralysis after surgery and those who developed paralysis or sequelae. The relationship between the patient's pre- and postoperative House-Brackmann staging and potential changes detected during surgery was investigated. Results: Paralysis was detected in 8 of 29 nerves that were stimulated, and the affected branches were the cervicofacial branch and the marginal mandibular branch. No difference was observed in the mean threshold stimulation values and responses determined before, during and at the end of dissection between patients who developed paralysis and those who did not. Conclusion: Unlike the literature, it is determined that no electrophysiological measurement result can predict the postoperative phase as a result of ROC-curve analysis and logistic regression analysis. It is thought that these results are caused by the fact that the developing paralysis is at low stages and heal within one month.

Identification of critical drought thresholds affecting vegetation on the Mongolian Plateau

The increasing frequency of drought events due to global climate change has significant impacts on ecosystems, often resulting in reduced vegetation productivity. However, vegetation responses to drought often exhibit non-linear threshold phenomena, where vegetation growth sharply decreases once water stress reaches a certain level. Our study, conducted on the Mongolian Plateau, focuses on revealing the drought response thresholds and distribution patterns of different vegetation types. These thresholds mark critical turning points from high drought resistance to high vulnerability in vegetation response and serve as early warning indicators, crucial for accurately assessing how terrestrial ecosystems adapt to climate change. We utilized remote sensing observation datasets and inversion datasets spanning from 2001 to 2020, including six representative vegetation indices. The results indicate that: (1) Over 70 % of the Mongolian Plateau experiences low vegetation growth (<10th) predominantly influenced by drought, with low vegetation growth often occurring when water availability falls below the 30th percentile; (2) Areas with higher vegetation coverage and relatively moist climates have lower proportions of drought thresholds, implying that more complex ecosystems can better mitigate water stress, while background climatic conditions also regulate vegetation response to water availability; (3) According to multi-model climate predictions, the overall probability of drought risk on the Mongolian Plateau is projected to significantly increase during 2080–2100, especially in drought-prone regions. These findings provide important insights into better understanding the impacts of drought on ecosystems. Additionally, they emphasize the urgency of taking early measures to adapt to future drought risks.

Deletion of the Ebf1, a mouse deafness gene, causes a dramatic increase in hair cells and support cells of the organ of Corti.

Following up on our previous observation that early B cell factor (EBF) sites are enriched in open chromatin of the developing sensory epithelium of the mouse cochlea, we investigated the effect of deletion of Ebf1 on inner ear development. We used a Cre driver to delete Ebf1 at the otocyst stage before development of the cochlea. We examined the cochlea at postnatal day (P) 1 and found that the sensory epithelium had doubled in size but the length of the cochlear duct was unaffected. We also found that deletion of Ebf1 led to ectopic sensory patches in the Kölliker's organ. Innervation of the developing organ of Corti was disrupted with no obvious spiral bundles. The ectopic patches were also innervated. All the extra hair cells (HCs) within the sensory epithelium and Kölliker's organ contained mechanoelectrical transduction channels, as indicated by rapid uptake of FM1-43. The excessive numbers of HCs were still present in the adult Ebf1 conditional knockout (cKO) animal. The animals had significantly elevated auditory brainstem response thresholds, suggesting that this gene is essential for hearing development.

Fitting parameters in children with cochlear implants and severe additional disabilities.

The aim of this study was to investigate whether the fitting data of children with Cochlear implants (CI) and severe additional disabilities (CAD) differ compared to children with CI but without additional disabilities (CnonAD). In this retrospective analysis, 76 CI cases (fitted ears) from CAD were included and matched with 76 cases from CnonAD. The subjective set values, such as pulse width (PW), threshold (T) and most comfortable (MC) levels were recorded. Additionally, the response threshold values by means of aided soundfield threshold (AST), the values of the intracochlear electrode impedances, the eCAP thresholds and the daily wearing time by using data logging were recorded and analysed. The T and MC levels for the Medel implants were significantly lower in the sample than in the control group. A similar trend was evident for Cochlear® implants. The sample showed a positive correlation between the eCAP thresholds and the T level and MC level in case of the Cochlear implants. The CAD group showed a significantly higher aided soundfield threshold. In contrast to the CnonAD (0%), there was a total of 18% in the CAD with a reduced daily wearing time. When these were excluded, eCAP thresholds were significantly higher in the CAD group. In addition, there was a trend for eCAP thresholds to be higher if the contralateral ear was not also fitted with a CI. The significantly higher eCAPs in CAD may be explained by different neural survival but also by different fittings and MC levels. The audiuologist's subjectivity must be considered as a potential bias but also as potentially valuable input variable contributing to the variance in the fitting parameters and outcomes. Better fitting of T and MC levels focusing on behavioural and developmental responses may lead to a longer wearing time. To support the audiologist and the fitting process, it is necessary to interpret the response thresholds in the aided soundfield threshold against the background of the medical diagnosis and observations from everyday life should be considered. To ensure optimal development of CAD children according to their individual abilities, a multi-professional, family-centred intervention programme including videoanalyses should be implemented at an early stage, ideally from the decision process for a cochlear implant.

Benefit of Modulated Masking in hearing according to age

ObjectiveTo analyze the Benefit of Modulated Masking (BMM) on hearing in young, adult and elderly normal-hearing individuals. MethodsThe sample included 60 normal-hearing individuals aged 18–75 years who underwent behavioral assessment (sentence recognition test in the presence of steady and modulated noise) and electrophysiological assessment (cortical Auditory Evoked Potential) to investigate BMM. The results were analyzed comparatively using the paired t-test and ANOVA for repeated measures, followed by the Bonferroni post-hoc test (p-value < 0.05). ResultsA decrease in latencies and an increase in amplitudes of cortical components (P1-N1-P2) was observed due to noise modulation in all age groups. Modulated noise generated better auditory threshold responses (electrophysiological and behavioral), compared to steady noise. The elderly presented a higher threshold in both hearing domains, compared to the other participants, as well as a lower BMM magnitude. ConclusionIt was possible to conclude that the modulated noise generated less interference in the magnitude of the neural response (smaller latencies) and in the neural processing time (larger amplitudes) for the speech stimulus in all participants. The higher auditory thresholds (electrophysiological and behavioral) and the lower BMM magnitude observed in the elderly group, even in the face of noise modulation, suggest a lower temporal auditory performance in this population, and may indicate a deficit in the temporal resolution capacity, associated with the process of aging. Level of evidence3.

Developmental plasticity of the cardiovascular system in oviparous vertebrates: effects of chronic hypoxia and interactive stressors in the context of climate change.

Animals at early life stages are generally more sensitive to environmental stress than adults. This is especially true of oviparous vertebrates that develop in variable environments with little or no parental care. These organisms regularly experience environmental fluctuations as part of their natural development, but climate change is increasing the frequency and intensity of these events. The developmental plasticity of oviparous vertebrates will therefore play a critical role in determining their future fitness and survival. In this Review, we discuss and compare the phenotypic consequences of chronic developmental hypoxia on the cardiovascular system of oviparous vertebrates. In particular, we focus on species-specific responses, critical windows, thresholds for responses and the interactive effects of other stressors, such as temperature and hypercapnia. Although important progress has been made, our Review identifies knowledge gaps that need to be addressed if we are to fully understand the impact of climate change on the developmental plasticity of the oviparous vertebrate cardiovascular system.

Uncovering habitat associations and thresholds—insights for managing breeding waterfowl in Eastern Canada

ContextUnderstanding how habitat influences species abundance is crucial in developing ecologically sound wildlife conservation management plans. Exploring habitat associations and ecological thresholds in species’ responses allows for better conservation and management on a landscape-scale.ObjectivesThis work aimed to identify habitat drivers and response thresholds of waterfowl and waterbird species’ densities in eastern Canada to support key landscape-level decisions for habitat conservation and wetland management.MethodsWe developed predictive abundance models for 17 species across eastern Canada from 2001 to 2015 using data from four regional surveys and identified areas where prioritizing enhancement of wetlands would increase the breeding density of five priority waterfowl species.ResultsHabitat associations and spatial abundance patterns varied across species, but most species responded strongly to forest composition, agriculture, and wetland features. Threshold effects occurred and varied among species, yet generally once 14% of a plot was covered in wetlands, positive effects of increased wetland diminished for most species. Our results allow for the targeting of investments in increasing wetland area along portions of eastern Canada that provide the best opportunities to increase breeding densities for priority waterfowl species.ConclusionsUnderstanding species-habitat associations and response thresholds allows for landscape management and planning and prioritization of limited resources. We suggest that management and wetland enhancement efforts for waterfowl in eastern Canada should be guided by predictive models and response thresholds of key habitat attributes to best prioritize actions that will have the biggest positive impact on multiple species.

Online Adaptive Kalman Filtering for Real-Time Anomaly Detection in Wireless Sensor Networks.

Wireless sensor networks (WSNs) are essential for a wide range of applications, including environmental monitoring and smart city developments, thanks to their ability to collect and transmit diverse physical and environmental data. The nature of WSNs, coupled with the variability and noise sensitivity of cost-effective sensors, presents significant challenges in achieving accurate data analysis and anomaly detection. To address these issues, this paper presents a new framework, called Online Adaptive Kalman Filtering (OAKF), specifically designed for real-time anomaly detection within WSNs. This framework stands out by dynamically adjusting the filtering parameters and anomaly detection threshold in response to live data, ensuring accurate and reliable anomaly identification amidst sensor noise and environmental changes. By highlighting computational efficiency and scalability, the OAKF framework is optimized for use in resource-constrained sensor nodes. Validation on different WSN dataset sizes confirmed its effectiveness, showing 95.4% accuracy in reducing false positives and negatives as well as achieving a processing time of 0.008 s per sample.

High stakes slow responding, but do not help overcome Pavlovian biases in humans.

"Pavlovian" or "motivational" biases are the phenomenon that the valence of prospective outcomes modulates action invigoration: the prospect of reward invigorates actions, while the prospect of punishment suppresses actions. Effects of the valence of prospective outcomes are well established, but it remains unclear how the magnitude of outcomes ("stake magnitude") modulates these biases. In this preregistered study (N = 55), we manipulated stake magnitude (high vs. low) in an orthogonalized Motivational Go/NoGo Task. We tested whether higher stakes (a) strengthen biases or (b) elicit cognitive control recruitment, enhancing the suppression of biases in motivationally incongruent conditions. Confirmatory tests showed that high stakes slowed down responding, especially in motivationally incongruent conditions. However, high stakes did not affect whether a response was made or not, and did not change the magnitude of Pavlovian biases. Reinforcement-learning drift-diffusion models (RL-DDMs) fit to the data suggested that response slowing was best captured by stakes prolonging the non-decision time. There was no effect of the stakes on the response threshold (as in typical speed-accuracy trade-offs). In sum, these results suggest that high stakes slow down responses without affecting the expression of Pavlovian biases in behavior. We speculate that this slowing under high stakes might reflect heightened cognitive control, which is however ineffectively used, or reflect positive conditioned suppression, i.e., the interference between goal-directed and consummatory behaviors, a phenomenon previously observed in rodents that might also exist in humans. Pavlovian biases and slowing under high stakes may arise in parallel to each other.

Interpretable Causal System Optimization Framework for the Advancement of Biological Effect Prediction and Redesign of Nanoparticles.

Nanomedicine has promising applications in disease treatment, given the remarkable safety concerns (e.g., nanotoxicity and inflammation) of nanomaterials, and realizing the trade-off between the immune response and organ burden of NPs and deeply understanding the interactions of the organism-nano systems are crucial to facilitate the biological applications of NPs. Here, we propose an interpretable causal system optimization (ICSO) framework and construct the upstream and downstream tasks of accurate prediction and intelligent NP optimization. ICSO framework screens the key drivers (recovery duration, specific surface area, and nanomaterial size) and potential causal information for immune responses and organ burden, revealing the hidden priming/constraint effects in bionano interactions. ICSO can be used to quantify the thresholds of biological responses to multiple properties (e.g., the specific surface area, diameter, and zeta potential). ICSO provides quantitative information and constraint conditions for the design of highly biocompatible and targeted organ delivery nanomaterials. For example, negative inflammation is reduced by 36.19%, and positive lung accumulation is promoted by 40.14% by optimizing the specific surface areas and shape and increasing the diameter-to-length ratio. ICSO overcomes the limitations of experience-dependent approaches and provides powerful and automated solutions for decision-makers during nanomaterial design.

Hearing, balance, and imaging assessment in adolescent Menière's disease: A retrospective analysis.

To retrospectively analyze clinical features in adolescent Menière's disease (MD). The medical records of adolescents with MD (11-17 years old) from May 2014 to March 2023 in Shandong Provincial ENT Hospital were retrospectively analyzed, including clinical features, a battery of auditory and vestibular function tests, sensory organization test, and imaging assessments. Patients with recurrent vertigo of childhood (RVC) were as controls. Compared with RVC, adolescent MD showed higher pure tone average threshold (p < .001), lower speech discrimination score (p = .014), and lower otoacoustic emission pass rates (p = .005). Adolescents with MD exhibited significant reduction in equilibrium score (Conditions 1, 5, and 6; p1 = .035; p5 = .033; p6 = .003), composite sensory score (p = .014), and vestibular sensory score (p = .029). Adolescents with bilateral MD exhibited worse performance in equilibrium score and strategy score compared to adolescents with unilateral MD. For the affected ear, the more severe endolymphatic hydrops detected by gadolinium-enhanced magnetic resonance imaging, the higher the auditory brainstem response threshold (r = .850, p = .007), and the lower the otoacoustic emission pass rate (r = -.976, p < .001). Adolescent MD has similar vestibular information inputs with that of RVC, but the ability for the nerve center to use these clues to maintain balance is worse in adolescents with MD. There were potential differences in vestibular weights in adolescents with unilateral and bilateral MD, also potential effects on vision and proprioception. Level 4.

The effectiveness of curcumin as a safe agent on hearing threshold improvement in patients with chronic kidney disease: a double-blind, placebo-controlled trial

Hearing impairment in patients with chronic kidney disease (CKD), can affect the quality of life. At present, hearing dysfunction does not have an approved pharmacologic therapy. This study aimed to investigate the protective effects and possible mechanisms of curcumin as a therapeutic agent on hearing impairment in patients with chronic kidney disease. We conducted a randomized controlled trial of 40 chronic kidney disease patients not on dialysis with hearing impairment. Participants were randomly divided into two groups. One group received curcumin daily and the other received a placebo for 12 weeks. The interval between III and V waves, latency of wave V, auditory brain stem response (ABR) threshold, speech reception threshold (SRT), and speech discrimination score (SDS) were evaluated and analyzed before and after the intervention. After treatment, in the curcumin group, III–V waves interval and the latency of wave V were significantly reduced (P value < 0.0001), also ABR threshold was demonstrated a significant improvement (P value < 0.0001). In the trial group, the SDS was increased (P = 0.001) and the SRT was attenuated (P < 0.0001). We had either significant deterioration due to the course of the disease or insignificant changes in the placebo group. Daily administration of curcumin, can significantly improve hearing impairment in CKD patients. Accordingly, curcumin should be considered as a therapeutic option for treating hearing impairment in patients with chronic kidney disease.

FUNDAMENTAL LIMITATIONS OF KILOHERTZ-FREQUENCY CARRIERS IN AFFERENT FIBER RECRUITMENT WITH TRANSCUTANEOUS SPINAL CORD STIMULATION.

The use of kilohertz-frequency (KHF) waveforms has rapidly gained momentum in transcutaneous spinal cord stimulation (tSCS) to restore motor function after paralysis. However, the mechanisms by which these fast-alternating currents depolarize efferent and afferent fibers remain unknown. Our study fills this research gap by providing a hypothesis-and evidence-based investigation using peripheral nerve stimulation, lumbar tSCS, and cervical tSCS in 25 unimpaired participants together with computational modeling. Peripheral nerve stimulation experiments and computational modeling showed that KHF waveforms negatively impact the processes required to elicit action potentials, thereby increasing response thresholds and biasing the recruitment towards efferent fibers. While these results translate to tSCS, we also demonstrate that lumbar tSCS results in the preferential recruitment of afferent fibers, while cervical tSCS favors recruitment of efferent fibers. Given the assumed importance of proprioceptive afferents in motor recovery, our work suggests that the use of KHF waveforms should be reconsidered to maximize neurorehabilitation outcomes, particularly for cervical tSCS. We posit that careful analysis of the mechanisms that mediate responses elicited by novel approaches in tSCS is crucial to understanding their potential to restore motor function after paralysis.

Threshold responses and relationships between waterbird distribution and habitat factors at Shengjin Lake, China

The wintering period is an essential part of the annual life history of waterbirds. The environmental conditions of habitats in winter directly affect the abundance and physical condition of waterbirds. Therefore, it is important to study the relationship between waterbird abundance and habitat factors. In this study, we conducted significance and threshold analyses between habitat factors and the waterbird community at Shengjin Lake, a Ramsar Site in China, using Redundancy Analysis (RDA), Spearman Correlation Analysis, and Threshold Indicator Taxa Analysis (TITAN). The results indicate that seven environmental variables significantly affected the abundance of waterbird communities, that is, fractional vegetation cover, degree of receding water, grassland area, mudflat area, shallow water area, deep water area, and distance to reeds. Waterbird communities exhibited significant threshold responses to all seven factors. The number of species significantly responding to different habitat factors varied among waterbird communities, with the highest number of species (15) responding to distance to reeds. Except for the deep water area and distance to reeds, waterbirds showed higher positive than negative thresholds for the remaining five factors. Different groups of waterbirds influenced the threshold responses of waterbird communities to habitat factors, and there were variations in how each waterbird group responded to these factors. The results of this study highlight the importance of habitat type, water recession degree, and shelter conditions in waterbird habitat selection. Minor differences in habitat structure can influence waterbird habitat preferences. Therefore, wetland management at Shengjin Lake should consider the specific habitat needs of different waterbird species.

Sounding out the river: Seismic and hydroacoustic monitoring of bedload transport

AbstractSeismological observations provide a non‐invasive and continuous means for indirectly measuring fluvial bedload transport. A significant challenge remains in independently characterising the seismic signature of bedload transport from other sources such as turbulence. We present a unique dataset from an alluvial Scottish river, combining seismic data and hydroacoustic measurements, to analyse bedload transport during three high‐flow events occurring within the same year. By studying three successive events, we assess the consistency of bedload transport thresholds in response to changing flow conditions and explore the presence of hysteresis in seismic data versus water level as an indicator of coarse bedload transport. Through the use of hydroacoustic data to independently characterise bedload transport, our findings reveal that bedload transport occurred during all three events but that the threshold for entrainment varied. These entrainment thresholds were influenced by antecedent events, with a drop of 15%–20% of the threshold flow depth following the largest of the three events. In agreement with recent studies, we also found that hysteresis in the seismic versus water level data is not sufficient for identifying and analysing bedload transport: Distinct hysteresis was only observed during the largest of the three events despite all events experiencing bedload transport as observed through the independent hydroacoustic data. Our work shows the value in combining independent datasets for long‐term monitoring of bedload transport to understand the evolution in the thresholds of bedload motion, providing crucial information for effective river and land‐use management in a changing climate with potentially impacted high‐flow events.

Examining aldosterone plasma concentration alterations post-ACTH stimulation in healthy subjects: a systematic literature review and meta-analysis on ACTH's role in aldosterone secretion.

Adrenocorticotropic hormone (ACTH), in addition to the renin-angiotensin-aldosterone axis, is a potent aldosterone stimulator, suggesting a potential contribution to conditions associated with increased ACTH concentrations. This study aims to systematically review and synthesize the scientific evidence of alterations of plasma aldosterone concentrations in response to ACTH stimulation during the cosyntropin (Synacthen) test and define the range of aldosterone response. A systematic search of PubMed, Medline, and Google Scholar databases according to PRISMA guidelines was performed. Only studies that assessed the alterations in plasma aldosterone concentrations following ACTH stimulation in healthy individuals were included. We incorporated studies that utilized the doses of 1μg, 250μg, 0.125μg/m2, or 0.5μg/m2 of ACTH. Out of 1599 initially assessed articles, 17 were deemed relevant to our research. The selected articles were assessed by two independent investigators based on the predetermined inclusion and exclusion criteria. Finally, eight full-text articles were included. The analyzed studies revealed a significant increase in plasma aldosterone concentrations in healthy subjects after ACTH stimulation, irrespective of the ACTH dose. The peak aldosterone concentration after the 250μg dose occurred at 30min, whereas smaller doses exhibited an earlier peak, at around 15min. On average, plasma aldosterone concentration increased by 125.5% after the 1μg and 0.5μg/m2 doses, and by 189.6% after 250μg. The presented evidence strongly supports the contribution of ACTH to aldosterone secretion regulation beyond the renin-angiotensin-aldosterone axis. Establishing a normal aldosterone response threshold following standardized ACTH stimulation could aid in identifying individuals with ACTH-dependent aldosterone hypersecretion and guide personalized and effective treatment strategies.

Research on the distribution and influencing factors of fine mode aerosol optical depth (AODf) in China

Analyzing the distribution and causes of fine mode aerosol optical depth (AODf) is important for assessing the impact of air pollution on human health and sustainable development. Based on remote sensing data and station information, the study uses Theil Sen's method and the Mann-Kendall test to analyze the spatio-temporal distribution and trends of AODf. Meanwhile, the study used the Extreme Gradient Boosting (XGBoost) model and the Shapley Additive Explanations (SHAP) algorithm to analyze the spatial drivers of AODf and interactive effects. The results show a trend of an initial increase followed by a decline in AODf across China and in most city clusters, with AODf peaking around 2011. Areas with high AODf are mainly concentrated in the eastern and central regions. On a seasonal scale, the average AODf is highest in summer (0.25), followed by winter (0.23), autumn (0.21), and spring (0.19). The AODf, mainly in the eastern and central regions, showed rapid increases and decreases in the 2000–2013 and 2013–2020 periods, respectively. Secondly, the most important factor influencing AODf is sulfate (SO4), contributing 54.84%. This is followed by elevation (DEM) at 10.31%. The SO4, organic carbon (OC), and DEM to AODf are 20–54%, 10–44%, and 11–45% respectively at the city cluster level. Lastly, the response thresholds of AODf to the main factors show significant spatial heterogeneity. The thresholds for SO4 and OC to increase AODf are in the range of 5–16 μg/m3 and 1–10 μg/m3, respectively. The study is of great importance for a comprehensive understanding of the variation patterns of AODf and for the formulation of tailored air pollution control policies based on local conditions.

Quantitative Analysis of the Effect of Neuromuscular Blockade on Motor-Evoked Potentials in Patients Undergoing Brain Tumor Removal Surgery: A Prospective, Single-Arm, Open-Label Observational Study.

Background: We aimed to elucidate the quantitative relationship between the neuromuscular blockade depth and intraoperative motor-evoked potential amplitudes. Methods: This prospective, single-arm, open-label, observational study was conducted at a single university hospital in Seoul, Korea, and included 100 adult patients aged ≥19 years undergoing brain tumor removal surgery under general anesthesia. We measured the neuromuscular blockade degree and motor-evoked potential amplitude in the deltoid, abductor pollicis brevis, tibialis anterior, and abductor hallucis muscles until dural opening. Results: The pharmacokinetic-pharmacodynamic model revealed the exposure-response relationship between the rocuronium effect-site concentration and motor-evoked potential amplitudes. The mean motor-evoked potential amplitudes decreased proportionally with increasing neuromuscular blockade depth. As the mean amplitude increased, the coefficient of variation decreased bi-exponentially. The critical ratio of the first evoked response to the train-of-four stimulation (T1)/control response (Tc) thresholds beyond which the coefficient of variation exhibited minimal change were found to be 0.63, 0.65, 0.68, and 0.63 for the deltoid, abductor pollicis brevis, tibialis anterior, and abductor hallucis muscles, respectively. Conclusions: Our results reveal that the motor-evoked potential amplitude exhibits deterioration proportional to the degree of neuromuscular blockade. In light of the observed bi-exponential decline of the coefficient of variation with the motor-evoked potential amplitude, we recommend maintaining a T1/Tc ratio higher than 0.6 for partial neuromuscular blockade.