Volume Variation Research Articles

Individualized blood pressure regulation and acute kidney injury in older patients having major abdominal surgery: a pilot randomized trial.

Acute kidney injury (AKI) is a common postoperative complication, and hypotension may contribute. We therefore tested the primary hypothesis that individualized intraoperative blood pressure regulation reduces postoperative AKI in older surgical patients. We enrolled patients ≥60years old scheduled for elective major abdominal surgery with invasive arterial pressure monitoring. All had goal-directed fluid management based on stroke volume variation and cardiac output, and administration of a starch. Participants were randomly assigned to: 1) individualized blood pressure management targeting a systolic blood pressure (SBP) within -20% and+10% if baseline SBP was ≥ 130mmHg or diastolic blood pressure was ≥ 80mmHg, or otherwise, to target SBP within±10% of the baseline value; 2) maintenance of SBP ≥ 90mmHg and MAP ≥ 65mmHg. Metaraminol was used to achieve the blood pressure target. AKI incidence was assessed by Kidney Disease Improving Global Outcomes criteria during the initial 7 postoperative days. 192 patients were assigned to individualized (n=96) or routine (n=96) pressure management. 179 patients were included in the intention-to-treat analysis. Age averaged 68±5 (SD) yr and 64% were male. Randomization to the individualized management reduced the area under MAP <65mmHg [median difference:-37 (-47 to -25) mmHg-min, P < 0.001]. The incidence of the AKI was 11% in patients assigned to individualized management versus 16 % in those assigned to routine management: relative risk 0.72 [95% CI 0.34 to 1.54], P=0.396. Patients assigned to individualized pressure management had more urine output, a shorter postoperative mechanical ventilation duration, and faster recovery of bowel function. Individualized blood pressure management markedly reduced hypotension. As expected in a pilot trial, the 28% reduction in AKI was not statistically significant. However, the reduction was clinically meaningful and suggests that a full trial is warranted.

Compositional brain scores capture Alzheimer's disease-specific structural brain patterns along the disease continuum.

Traditional multivariate methods for neuroimaging studies overlook the interdependent relationship between brain features. This study addresses this gap by analyzing relative brain volumetric patterns to capture how Alzheimer's disease (AD) and genetics influence brain structure along the disease continuum. This study analyzed data from participants across the AD continuum from the Alzheimer's and Families (ALFA) and Alzheimer's Disease Neuroimaging Initiative (ADNI) studies. Compositional data analysis (CoDA) was exploited to examine relative brain volumetric variations that (1) were linked to different AD stages compared to cognitively unimpaired amyloid-β-negative (CU A-) individuals and (2) varied by AD genetic risk. Disease stage-specific compositional brain scores were identified, differentiating CU A- individuals from those in more advanced stages. Genetic risk-stratified models revealed a broader genetic landscape affecting brain morphology in AD, beyond the well-known apolipoprotein E ε4 allele. CoDA emerges as an alternative multivariate framework to deepen understanding of AD-related structural changes and support targeted interventions for those at higher genetic risk. Compositional data analysis (CoDA) revealed the relative variation of brain region volumes, captured in compositional brain scores, capable of discerning between cognitively unimpaired amyloid-β-negative individuals and subjects within other disease-stage groups along the Alzheimer's disease (AD) continuum. CoDA also uncovered the genetic vulnerability of specific brain regions at each stage of the disease along the continuum. CoDA is capable of integrating magnetic resonance imaging data from two different cohorts without stringent requirements for harmonization. This translates as an advantage, compared to traditional methods, and strengthens the reliability of cross-study comparisons by standardizing the data despite different labeling agreements, facilitating collaborative and large-scale research. The algorithm is sensitive to AD-specific effects, as the main compositional brain scores display little overlap with the age-specific compositional brain score. CoDA provides a more accurate analysis of brain imaging data addressing its compositional nature, which can influence the development of targeted approaches, opening new avenues for enhancing brain health.

Rational Design Strategy of Multicomponent Si/FeSeOx@N‐Doped Graphitic Carbon Hybrid Microspheres Intertwined with N‐Doped Carbon Nanotubes as Anodes for Ultra‐Stable Lithium‐Ion Batteries

Herein, an efficient synthesis approach is introduced for the fabrication of a hybrid anode consisting of porous microspheres with biphasic silicon (Si)‐amorphous iron selenite (Si/FeSeOx) nanocrystals enveloped within an N‐doped graphitic carbon (NGC) matrix and encased by well‐grown, highly intertwined N‐doped carbon nanotubes (CNTs) (Si/FeSeOx@NGC/N‐CNT). Si and FeSeOx serve as the active components, contributing to the overall discharge capacity of the hybrid anode. Additionally, FeSeOx not only enhances the structural integrity of the nanostructure by channelizing the drastic volume variation of Si, but also expedites the diffusion of lithium ions, thereby promoting kinetically favored redox reactions. The NGC matrix serves as the primary pathway for efficient electron transfer within the electrode, whereas the well‐grown N‐CNTs network acts as a secondary pathway for subsequent electron transfer to the current collector. The porous structure achieved via selective removal of amorphous carbon ensures the smooth diffusion of charged species by shortening the effective charge diffusion length and accommodating the substantial volume changes during cycling. Correspondingly, the Si/FeSeOx@NGC/N‐CNT anodes demonstrate significant enhancements in electrochemical performance, including one‐order higher diffusion coefficients (≈10−12 cm2 s−1), exceptional rate capability (till 30 A g−1), and extraordinary cycling stability at 0.5, 1.0, and 3.0 A g−1.

Rivaroxaban versus low molecular weight heparin for managing lower extremity deep vein thrombosis following thoracoscopic lung cancer surgery: a randomized controlled trial

ObjectiveTo assess the effectiveness and safety profiles of rivaroxaban compared to low molecular weight heparin (LMWH) in managing lower extremity deep vein thrombosis (DVT) subsequent to thoracoscopic lung cancer surgery.MethodsSixty patients diagnosed with lower extremity deep vein thrombosis (DVT) following thoracoscopic lung cancer surgery were randomly assigned to two groups: the experimental group comprising 30 patients treated with rivaroxaban, and the control group consisting of 30 patients treated with low molecular weight heparin (LMWH). The fundamental clinical characteristics of patients in both groups were documented, encompassing parameters, along with pre- and post-surgical lower limb vascular ultrasound findings. Additionally, variations in drainage volume over the initial three days following the procedure were also noted. Patients were subjected to a three-month follow-up period, during which data from one-month and three-month postoperative examinations were collected.ResultsPatients from both groups exhibited satisfactory wound healing postoperatively. D-dimer levels remained stable, and lower extremity vascular ultrasound evaluations showed no signs of additional thrombus formation. Moreover, there were no reported cases of distant postoperative complications such as pleural effusion, gingival bleeding, or gastrointestinal bleeding. Nonetheless, subcutaneous bruising was observed in six patients from the control group, all localized at the sites of LMWH injections.ConclusionRivaroxaban demonstrates efficacy comparable to LMWH in patients with lower extremity deep vein thrombosis following thoracoscopic lung cancer surgery, while exhibiting a superior safety profile compared to LMWH.

Dependence of rainfall–runoff model performance on calibration conditions under changing climatic conditions

ABSTRACT Calibration period selection is crucial for rainfall–runoff (RR) models in stationary and non-stationary climates. In this study, we assessed the impact of four calibration conditions on RR model performance: calibration duration, temporal lag between calibration and simulation periods, variation in rainfall volume, and rainfall patterns similarity. To ensure the generalizability of our findings, we used five RR models (GR4J, Simhyd, WASMOD, HBV, and XAJ) to simulate streamflow across two catchments in Iran with stationary and non-stationary climate conditions. Our results show that catchments exhibiting non-stationary RR relationships necessitate longer calibration periods to obtain stable simulations. Model performance gradually drops as the temporal lag between the calibration and simulation periods increases. This drop in performance is even more pronounced in catchments experiencing non-stationary climate conditions. Similarity in rainfall volume is more important than rainfall pattern similarity for predicting future streamflow in non-stationary RR relationships.

Study on the Ablation Behavior of High-Intensity Lasers in Vacuum

Laser ablation has been extensively studied by researchers due to its high precision, high efficiency processing capabilities, and wide range of application potentials. However, in a vacuum environment, due to the complexity of experimental conditions, specific application scenarios, and interdisciplinary interferences, more in-depth research on the ablation behavior of high-intensity lasers in vacuum is still insufficient. In response to such issues, experiments were conducted on titanium alloy perforation using a nanosecond laser in a vacuum environment. The variations in ablation depth and volume as functions of pulse energy, pulse number, and defocus were investigated. Both the depth and volume ablation efficiencies were calculated, and the three-dimensional morphology of the ablation holes was captured. Additionally, the ablation plume was observed to support the research conclusions. The results indicate that within the number of high-intensity laser pulses, the ablation depth per pulse can be increased by more than four times, and the average ablation volume per pulse can reach 0.97 µm3/µJ. The enhanced sputtering of molten material during the multi-pulse laser ablation process in a vacuum environment is identified as the primary factor contributing to the increased ablation efficiency. With the advancement of science and technology and the growing demand for applications, this research is crucial for the further development of fields such as space exploration and technology, advanced manufacturing technology, and basic scientific research.

Higher hospital volume reduces early failure rates in single-stage revision TKR for infection: An analysis of the United Kingdom National Joint Registry and National Administrative Databases.

Revision knee replacement (RevKR) for infection is rare but increasing. It is hypothesised that higher hospital volume reduces adverse outcomes. The aim was to estimate the association of surgical unit volume with outcomes following first, single-stage RevKR for infection. This population-based cohort study merged data from the United Kingdom National Joint Registry, Hospital Episode Statistics, National Patient Reported Outcome Measures and the Civil Registrations of Death. Patients undergoing procedures between 1 January 2009 and 30 June 2019 were included. Early outcomes were chosen to reflect the quality of the surgical provision and included re-revision at 2 years, mortality, serious medical complications, length of stay and patient-reported outcome measures (PROMs). Adjusted fixed effect multivariable regression models were used to examine the association between surgical unit mean annual caseload and the risk of adverse outcomes. A total of 1477 patients underwent first-time single-stage RevKRs for infection across 267 surgical units and 716 surgeons. Following adjustment for age, gender, American Society of Anaesthesiologists grade, surgeon volume, year of surgery and operation funder and modelling surgical unit volume with restricted cubic spline, a greater mean annual volume was associated with a lower risk of re-revision at 2 years. The odds of re-revision in hospitals performing fewer than or equal to 12 cases per year was 2.53 (95% confidence interval = 1.50-4.31) times more likely than hospitals performing three to four cases per month. Annual variation in surgical unit volume was not associated with mortality and serious medical complications within 90 days. Only 99 out of 1477 (7%) of patients had linked PROMs which precluded subsequent analysis. Overall, higher volume surgical units had lower rates of early re-revision following the first RevKR for infection. We were unable to provide recommended specific volume thresholds for units; however, the probability of re-revision appears to be lowest in the highest volume units. Level III, retrospective cohort study of prospectively collected data.

Current Concepts in Fluid Resuscitation and Vasopressor Use in Cirrhosis.

Critically ill patients with cirrhosis and liver failure not uncommonly have hypotension due to multifactorial reasons, that include hyperdynamic state with increased cardiac index, low systemic vascular resistance due to portal hypertension, following the use of beta blocker or diuretic therapy, and severe sepsis. These changes are mediated by microvascular alterations in the liver, systemic inflammation, activation of renin angiotensin aldosterone system, and vasodilatation due to endothelial dysfunction. Hemodynamic assessment includes measuring inferior vena cava indices, cardiac output and systemic vascular resistance using point-of-care ultrasound (POCUS), in addition to arterial waveform analysis, or pulmonary artery pressures, and lactate clearance to guide fluid resuscitation. Fluid responsiveness reflects the ability of fluid bolus to increase the cardiac output and is assessed effectively by POCUS, passive leg raise manoeuvre, and dynamic tests such as pulse pressure and stroke volume variation both in spontaneously breathing and mechanically ventilated patients. Albumin has pleotropic benefits through anti-inflammatory properties besides its standard action on oncotic pressure and volume expansion in patients with cirrhosis but has potential for precipitating pulmonary edema. In conclusion, fluid therapy in critically ill patients with liver disease is a complex and dynamic process that requires individualised management protocols to optimise patient outcomes.

Evaluating Annual Growth Dynamics Across Forest Types Using Permanent Sample Plots in Yellapur Forest Division, Karnataka, India

Annual tree increment requires repeated assessments on permanent sample plots, which are crucial for evaluating changes in tree size and stem volume. These plots enable long-term monitoring to estimate timber production and analyse growth dynamics. This study examines the current annual increment of growth parameters like tree height, GBH, basal area, and volume in dry, moist deciduous, and semi-evergreen forests within the Yellapur Forest Division, Uttara Kannada, Karnataka. The Permanent sample plots were utilized to assess growth patterns across various forest types. Total of nine one-hectare permanent plots were established across the forest types with three plots laid in each forest type and divided into subplots of size 33.33m× 33.33m and data were collected for tree parameters including girth at breast height and tree height using digital laser hypsometer. Measurements were conducted over two consecutive years i.e., in 2022 and repeated in 2023 to calculate CAI. The results revealed significant variation among forest types. Moist deciduous forests exhibited the highest CAI in height (0.45 m/year) and GBH (1.84 cm/year), while dry deciduous forests showed lower increments due to water stress and leafless periods. Semi-evergreen forests, although with dense canopy competition, demonstrated moderate growth rates. The basal area increment was highest in moist deciduous forests (0.93 m²/ha/year), reflecting favourable moisture and nutrient conditions. The tree volume increased significantly in moist deciduous forests (22.80 m³/ha/year). Variations in basal area and volume suggest that environmental conditions and anthropogenic activities, such as litter collection, impacted growth across forest types. These insights are critical for developing sustainable forest management practices and mitigating the impact of anthropogenic activities on forest ecosystems. This research underscores the importance of monitoring permanent plots to understand forest dynamics and supports sustainable forest management strategies.

Influence of Low‐Grade Solid Potash Mineral Composition on Potassium Extraction and Lithium Distribution During Solution Mining in Mahai Salt Lake, Qaidam Basin

ABSTRACTAs high‐grade potash resources become increasingly scarce and lithium is recognised as a valuable co‐product, the low‐grade solid potash deposits in the Mahai Salt Lake, Qaidam Basin, have become increasingly significant targets for potash resource development. However, the inefficient release of potassium from these low‐grade ores constrains their economic feasibility for industrial use. This study addresses this challenge by employing x‐ray diffraction (XRD), scanning electron microscopy coupled with energy dispersive spectroscopy (SEM‐EDS), and observational borehole monitoring data to systematically analyse the mineralogical characteristics of these ores and their influence on potassium ion release during solid–liquid conversion. The results identify carnallite, sylvite, and polyhalite as the primary potash minerals, with a significant spatial variations across the study area that directly impact potassium ion release and migration. Sylvite and carnallite in shallow strata are more reactive with solvents, facilitating rapid potassium ion release, whereas polyhalite, hosted within the intercrystalline clastic materials of halite, demonstrates limited pore connectivity, resulting in a slower release rate. Monitoring borehole data indicate that variations in solvent injection volumes cause significant fluctuations in water levels and potassium ion concentrations, thereby affecting potash dissolution rates. As solution mining progresses, high‐lithium areas gradually expand, with lithium concentrations in brine reaching up to 120.4 mg/L and generally ranging from 20 to 70 mg/L. The spatial correlation between potassium and lithium distribution suggests that lithium can be effectively recovered as a co‐product. Adjustments in solvent injection rates and concentrations, based on mineral distribution and monitoring data, are essential for optimising the dissolution efficiency of both potassium and lithium during production.

Deciphering Groundwater-Surface water Interactions using Environmental Tracers in a Tropical Lake, Southwest India

This study focuses on identifying GW-SW interaction locations in a tropical lake - Vellayani Lake (VL), Southwest India, utilizing stable water isotopes (s18O, sD) and chloride mass balance approach. The northern lake region was identified as a critical groundwater discharge “hotspot” with pronounced discharge (2.14×106 - 3.82×106 m³/yr), prompting targeted management interventions. This reaffirms the critical role of groundwater inflow in sustaining the lake’s water balance. Additionally, the application of machine learning (ML) techniques refined the classification of Lacustrine Groundwater Discharge (LGD) and non-LGD sites while predictive modeling utilizing Sensitivity Indices enhanced the understanding of prominent factors influencing lake volume. K-means clustering and Random Forest (RF) classification, achieved high accuracy (90%) and a kappa value of 0.8 in distinguishing groundwater discharge and non-discharge sites. Predictive modeling and sensitivity analysis revealed precipitation as the most influential factor, with a ±20% change causing a 16.69% variation in lake volume. Groundwater discharge exhibited a sensitivity index of 0.5320, further emphasizing its critical role in maintaining lake hydrological balance. This integrated approach provided valuable insights into the critical role of nearshore groundwater recharge in maintaining lake hydrological balance and facilitates the identification of suitable areas for groundwater recharge structures. For practitioners and policymakers, this integrated approach offers a robust framework for identifying critical GW-SW interaction zones, prioritizing groundwater recharge areas, and designing sustainable water management strategies, especially in data-scarce regions, paving the way for improved resource management in similar tropical lake environments.

Actin instability alters red blood cell mechanics and Piezo1 channel activity.

The organization and dynamics of the spectrin-actin membrane cytoskeleton play a crucial role in determining the mechanical properties of red blood cells (RBC). RBC are subjected to various forces that induce deformation during blood microcirculation. Such forces also regulate membrane tension, leading to Piezo1 channel activation, which is functionally linked to RBC dehydration through calcium influx and subsequent activation of Gardos channels, ultimately resulting in variations in RBC volume. In this study, we investigated how actin instability affects Piezo1 channel gating, in relation to RBC deformation and mechanical properties, using micropipette aspiration and optical tweezers. Actin instability, induced by 0.5μM Cytochalasin-D (Cyt-D), led to a 22% reduction in the activation pressure. Additionally, we observed a decreasing trend in Young's modulus, membrane tension, and viscosity. By measuring the time required for cell shape recovery after deformation in an optical trap, we found that Cyt-D-treated RBC took approximately 14% longer to recover compared to untreated cells. The bimodal imaging feature of our experimental approach allowed us to simultaneously measure and correlate activation pressure with mechanical properties at the single-cell level. A significant correlation was found between these parameters in both treated and untreated RBC. Our findings demonstrate the influence of actin instability on both Piezo1 activation and RBC mechanics. These results offer new insights into the interplay between F-actin and Piezo1 in RBC mechanobiology.

Precise Synthesis of 4.75 V-Tolerant LiCoO2 with Homogeneous Delithiation and Reduced Internal Strain.

The rapid advancements in 3C electronic devices necessitate an increase in the charge cutoff voltage of LiCoO2 to unlock a higher energy density that surpasses the currently available levels. However, the structural devastation and electrochemical decay of LiCoO2 are significantly exacerbated, particularly at ≥4.5 V, due to the stress concentration caused by more severe lattice expansion and shrinkage, coupled with heterogeneous Li+ intercalation/deintercalation reactions. Herein, employing the molten-salt synthesis technique, we propose a universal morphology-shaping strategy to attain bulk reaction homogeneity and reduce internal strains, even at extremely high charge voltages. The newly designed flattened polygon prismlike LiCoO2 (P-LCO) particle, featuring a regular symmetrical arrangement along the c-axis, demonstrates a more homogeneous Li+ extraction/insertion reaction, which results in a restrained transformation to detrimental O1 phase and reduced variation in lattice volume throughout the (de)lithiation processes. This benefits the mitigation of the local stress accumulation misfit dislocations and particle cracking, ultimately maintaining the mechanical stability of the cathode. Consequently, P-LCO is capable of breaking the voltage ceiling and exhibits exceptional long-term cycling capability at an ultrahigh voltage of 4.75 V. This work offers a brand-new perspective for the rational design of cathode morphology to address capacity deterioration caused by inhomogeneous delithiation and internal strain, thus inspiring the development of high-energy-density cathodes with improved durability.

Enhancing Mechanical Resilience in Li-Ion Battery Cathodes with Nanoscale Elastic Framework Coatings.

Lattice volume changes in Li-ion batteries active materials are unavoidable during electrochemical cycling, posing significant engineering challenges from the particle to the electrode level. In this study, we present an elastic framework coating designed to absorb and reversibly release strain energy associated with particle volume changes, thereby enhancing mechanical resilience at both the particle and electrode levels. This framework, composed of multiwalled carbon nanotubes (MWCNTs), is applied to nickel-rich LiNi0.9Co0.05Mn0.05O2 (NCM9055) cathodes at a low loading of 0.5 wt %, effectively mitigating critical issues such as particle cracking, volume changes, and electrode thickness variations during cycling. Leveraging these advantages, an energy-dense electrode is achieved with a high active material loading of 20 mg cm-2, without the need for additional carbon additives. Demonstrated in a pouch cell format, this electrode achieves an exceptional capacity retention of 77.7% after 1000 cycles. This approach provides a comprehensive solution for designing Li-ion batteries capable of withstanding lattice volume variations, offering valuable insights for next-generation batteries technologies.

The Role of the Estimated Plasma Volume Variation in Assessing Decongestion in Patients with Acute Decompensated Heart Failure.

Assessing decongestion in patients with acute decompensated heart failure (ADHF) is challenging, requiring multiple parameters and often remaining imprecise. The study aimed to investigate the utility of indirectly estimating plasma variation (∆ePVS) for evaluating decongestion in ADHF patients in relation to natriuretic peptides. This prospective, observational, single-center study included 111 patients (mean age 74 years, 40% female) hospitalized with ADHF and treated with intravenous diuretics along with optimized medical therapy. Patients were clinically and echocardiographically evaluated at admission, with blood tests performed at both admission and discharge. A decrease of ≥30% in NT-proBNP at discharge was considered a marker of decongestion. ∆ePVS was calculated using the Strauss formula: ∆ePVS (%) = 100 × [(Hb admission/Hb discharge) × (1 - Hct discharge)/(1 - Hct admission)] - 100. A negative ∆ePVS (<0%) at discharge was considered a marker of hemoconcentration. Patients were divided into two groups: G1 (∆ePVS < 0%, 81 patients) and G2 (∆ePVS ≥ 0%, 30 patients). Both groups had similar left ventricular ejection fraction (LVEF) values of 46%, mean hemoglobin (Hb) (12 g/dL), and creatinine (1.16 ± 0.65 mg/dL). NT-proBNP decreased in 88% patients in G1 and in 26% patients in G2 (p < 0.001). During hospitalization, five patients from G2 died. At 6 months, rehospitalization occurred in 35% of G2 and 21% of G1 (p = 0.04), with mortality rates of 37% in G2 and 11% in G1 (p = 0.012). Multivariate regression identified ∆ePVS as the only significant predictor of NT-proBNP decrease (OR 0.11, 95% CI 0.04-0.33, p < 0.001). Indirect estimation of plasma volume and its variation are valuable, accessible, and cost-effective parameters for assessing decongestive treatment in ADHF patients, complementing natriuretic peptides.

Plasma volume variations in response to high intensity interval training in obese women: The influential role of menopausal status and age.

This study aims to explore the effects of high-intensity interval training (HIIT) on plasma volume (PV) variations in obese women, with a focus on understanding how menopausal status and age influence these changes. We enrolled fifty-nine obese women (perimenopausal and postmenopausal), aged approximately 56.6 years in a six-week HIIT program. Measurements of fitness, health, and PV were taken before and after the intervention. PV was assessed at two points during each session: at post-warm-up (PV1), and immediately post-training (PV2). These measurements were derived using hematocrit (Ht) and hemoglobin (Hb) values. The intervention led to notable reductions in anthropometric measures and blood pressure (P < 0.01). For all women pre- and post-HIIT comparisons revealed significant differences in the extent of PV reduction at all two points (P < 0.01). Multiple linear regression analysis revealed that age was a significant contributor to the decreases in plasma volume (PV) observed both after warm-up and following the supramaximal cycling test - SCT (r = 0.44 and r = 0.57). On the other hand, menopause status was an independent predictor for PV decreases after warm-up (r = 0.33) as well after SCT (r = 0.38). Following HIIT, only menopause status accounted for 19 % of the variation in PV decreases after warm-up and 21 % of the variation in PV decreases after SCT. The findings suggest that HIIT is effective in enhancing plasma volume among obese menopausal women, attenuating the age-related decline in PV.

Deep learning model to identify and validate hypotension endotypes in surgical and critically ill patients.

Hypotension is associated with organ injury and death in surgical and critically ill patients. In clinical practice, treating hypotension remains challenging because it can be caused by various underlying haemodynamic alterations. We aimed to identify and independently validate endotypes of hypotension in big datasets of surgical and critically ill patients using unsupervised deep learning. We developed an unsupervised deep learning algorithm, specifically a deep learning autoencoder model combined with a Gaussian mixture model, to identify endotypes of hypotension based on stroke volume index, heart rate, systemic vascular resistance index, and stroke volume variation observed during episodes of hypotension. The algorithm was developed with data from 871 surgical patients who had 6962 hypotensive events and validated in two independent datasets, one including 1000 surgical patients who had 7904 hypotensive events and another including 1000 critically ill patients who had 53 821 hypotensive events. We defined hypotension as a mean arterial pressure <65 mm Hg for at least 1 min. In the development dataset, we identified four hypotension endotypes. Based on their physiological and clinical characteristics, we labelled them as: vasodilation, hypovolaemia, myocardial depression, and bradycardia. The same four hypotension endotypes were identified in the two independent validation datasets of surgical and critically ill patients. Unsupervised deep learning identified four endotypes of hypotension in surgical and critically ill patients: vasodilation, hypovolaemia, myocardial depression, and bradycardia. The algorithm provides the probability of each endotype for each hypotensive data point. Identifying hypotensive endotypes could guide clinicians to causal treatments for hypotension.

Brain structural differences in cocaine use disorder: Insights from multivariate and neurotransmitter analyses

Cocaine use disorder (CUD) is a chronic and relapsing neuropsychiatric disorder characterized by structural and functional brain lesions, posing a significant public health challenge. While the disruptive effects of cocaine on neurotransmitter systems (receptors/transporters) have been well established, the patterns of brain structural abnormalities in CUD and its interaction with other factors remain an ongoing topic of investigation. We employed source-based morphometry (SBM), a multivariate approach on 50 CUD participants and 50 matched healthy controls from the public SUDMEX CONN dataset. This method allowed us to identify co-varying patterns of brain tissue volume differences, and further explore the effect of average cocaine dosage through moderation analysis. Spatial correlation analysis was also performed to examine micro-macro structural consistency between tissue volume variations and chemoarchitectural distribution of dopamine and serotonin. Our SBM analysis findings were consistent with reward-related neuroadaptations in the striato-thalamo-cortical and limbic pathways and also exhibited co-localization with the distribution of dopamine and serotonin systems. The moderation analysis suggested that the average dosage positively strengthens cocaine consumption years' effect on brain structures. By integrating our findings of gray and white matter volume differences and corresponding neurotransmitter profiles, this comprehensive view not only strengthens our understanding of the brain's structural abnormalities in CUD, but also reveals potential mechanisms underlying its development and progression.

Dextran stabilised hematite: a sustainable anode in aqueous electrolytes.

During the last decades, the use of innovative hybrid materials in energy storage devices has led to notable advances in the field. However, further enhancement of their electrochemical performance faces significant challenges nowadays, imposed by the materials used in the electrodes and the electrolyte. Such problems include the high solubility of both the organic and the inorganic anode components in the electrolyte as well as the limited intrinsic electronic conductivity and substantial volume variation of the materials during cycling. The present work focuses on the fabrication of novel and sustainable anode electrodes for use in energy storage devices, utilizing cross-linked oxidized dextran (Ox-Dex) as the binder and hematite (α-Fe2O3) cubes as the active component. The ion diffusion mechanism within the anode electrode materials, as well as their cycling stability, were studied via cyclic voltammetry measurements, using Li+, Zn2+ and Al3+ aqueous electrolytes. The hybrid iron oxide electrodes exhibited the highest electrochemical performance in the Al2(SO4)3 electrolyte (3000 mA g-1), followed by ZnSO4 (2000 mA g-1) and Li2SO4 (800 mA g-1). The differences in the performance of the anodes for the three investigated electrolytes were attributed to the ionic radii of Li+, Zn2+ and Al3+, which affect the rate of ion diffusion within the material lattice exhibiting the highest diffusion coefficient of 4.64 × 10-9 cm2 s-1 in Al3+. Notably, the hybrid anodes demonstrated superior cycling performance (with the lowest variance percentage of 1.3% for hybrid compared to 38.1% for the bare in the presence of Zn2+), underlining the pivotal role of the natural binder. This was attributed to hydrogen bonding interactions, which increase the contact points between the inorganic and polymeric components, resulting in a more uniform network structure. Additionally, the cross-linking of Ox-Dex promotes stability and tolerance to the volume expansion of the electrodes. These results underscore the immense potential of the proposed hybrid electrodes in the field of energy storage.

Life cycle and morphogenetic differentiation in heteromorphic cell types of a cosmopolitan marine microalga.

Gephyrocapsa huxleyi is a prevalent, bloom-forming phytoplankton species in the oceans. It exhibits a complex haplodiplontic life cycle, featuring a diploid-calcified phase, a haploid phase and a third 'decoupled' phase produced during viral infection. Decoupled cells display a haploid-like phenotype, but are diploid. Here, we investigated the fate of decoupled cells during culture observations and we compared the transcriptome profiles and the cellular ultrastructure of the three life cycle cell types. We found that decoupled cells can revert to the calcified form in the absence of viral pressure, revealing the ability of G. huxleyi to modulate cell differentiation as a function of external conditions. Ultrastructural analyses showed distinct nuclear organization with variations in chromatin volume. Transcriptomic analyses revealed gene expression patterns specific to each life phase. These included multiple regulatory functions in chromatin remodeling, broader epigenetic mechanisms and life cycling, likely contributing to cell differentiation. Finally, analyses of available host-virus transcriptomes support life cycle transition during viral infection. This study provides cellular and molecular foundations for nuclear remodeling and cell differentiation in coccolithophores and the identification of gene markers for studying coccolithophore life cycles in natural populations.