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Background: Continuous positive airways pressure (CPAP) with a CPAP machine and mask has been shown to be more effective at minimising hypoxaemia than other devices under deep sedation. However, the efficacy of a new and simple CPAP device for spontaneously breathing obese patients during colonoscopy is unknown.Objective: We hypothesised that oxygenation and ventilation in obese patients under deep sedation during colonoscopy using CPAP via a new nasal mask (SuperNO2VA) would be better than routine care with oxygen supplementation via a nasal cannula.Design: Randomised study.Setting: Single-centre, June 2017 to October 2017.Patients: A total of 174 patients were enrolled and randomly assigned to Mask group or Control group. Thirty-eight patients were excluded and data from 136 patients underwent final analysis.Intervention: Patients in the Mask group were provided with nasal CPAP (10 cmH2O) at an oxygen flow rate of 15 l min. In the Control group, patients were given oxygen via a nasal cannula at a flow rate of 5 l min.Main Outcome Measures: The primary outcome was elapsed time from anaesthesia induction to the first airway intervention.Results: The elapsed time from anaesthesia induction to the first airway intervention was 19 ± 10 min in the Mask group (n=63) vs. 10 ± 12 min in the Control group (n=73, P < 0.001). In all, 87.5% (56/64) of patients achieved the target CPAP value. More patients in the Control group (63%) received airway intervention than in the Mask group (22%) (P < 0.001). Hypoxaemia (pulse oximeter oxygen saturation, SpO2 < 90%) occurred more frequently in the Control group (22%) than in the Mask group (5%) (P = 0.004). Minute ventilationPostinduction/minute ventilationBaseline and minute ventilationProcedure-end/minute ventilationBaseline was lower in the Control group than in the Mask group (P = 0.007 and 0.001, respectively).Conclusion: Application of a nasal mask at a target CPAP of 10 cmH2O improves ventilation and decreases the frequency and severity of hypoxaemia.Trial Registration: NCT03139448, registered at ClinicalTrials.gov. [ABSTRACT FROM AUTHOR]

The present study aimed to examine the hypothesis that vascular endothelial growth factor (VEGF) has a protective effect against cardiopulmonary bypass (CPB)-associated acute kidney injury (AKI). Eighteen male beagles were randomly allocated to three groups (n=6 per group): Sham group, animals received sternotomy without going through CPB; CPB group, animals received CPB only; VEGF group, animals received CPB and VEGF. VEGF infusion was completed 1 h prior to the initiation of CPB. Renal microcirculation perfusion, serum creatinine (SCr) and blood urea nitrogen (BUN), histopathological injury score and apoptotic index were determined. Hypoxia inducible factor-1α, VEGF, phosphorylated (p)-Akt serine/threonine kinase (Akt), p-endothelial nitric oxide synthase (eNOS), cleaved caspase-3, B-cell lymphoma 2 (Bcl-2) and cluster of differentiation (CD)95 expression levels were assessed by western blot analysis, Enzyme-linked immunosorbent assay quantitative assays were used to evaluate tumor necrosis factor (TNF)-α, interleukin (IL)-6, superoxide dismutase and malondialdehyde levels. Renal microcirculation perfusion of the VEGF group was higher than that of the CPB group (P<0.05) and lower than that of the sham surgery group (P<0.05). SCr and BUN were significantly elevated after CPB in the CPB and VEGF groups, with significantly lower levels in group VEGF than group CPB. Renal pathology scores and apoptotic indices were significantly lower in the VEGF group than the CPB group. Levels of TNF-α, IL-6 in the VEGF group were significantly lower than in the CPB group. Levels of VEGF, p-Akt, p-eNOS and Bcl-2 expression in the VEGF group increased significantly in comparison with group CPB. Cleaved caspase-3 in the VEGF group was significantly lower than in the group CPB. CPB-associated reduction of renal microcirculation perfusion may predispose to AKI. VEGF appears to provide a protective effect on the kidneys through improvement in renal microperfusion. [ABSTRACT FROM AUTHOR]

Purpose – The aim is to investigate and group the strategic motives that firms engage in cooperative R&D by exploring a new method. Design/methodology/approach – Four theories are adopted to explain the motives and they are cited as the base to categorize the motives into four factors. A survey questionnaire of participants in the aluminum industry is used to examine the empirical prevalence and clustering of these different categories of strategic motives. Factor analysis is used to test this measurement modeling. Findings – The results of the confirmatory factor analysis support this grouping of strategic motives as reliable and valid method. Research limitations/implications – The techniques used in this study when applied to group other motives or other similar issues could produce useful information in business and management research. Moreover, the theories employed in this research can help in hypothesis development and the relationship test between the factors and the formation of R&D alliances. Practical implications – The incentives such as strategic motives and the formation of R&D alliances studied in this paper can be used to investigate how they might be related to the aluminum or any other industry characteristics. Originality/value – This paper contributes to the modeling of measurement model in management by exploring a new method. [ABSTRACT FROM AUTHOR]