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Objectives Methods Results Conclusion Propofol is commonly used for endoscopic sedation. However, it can induce adverse hemodynamic effects. Remimazolam is known to have a fast onset and short duration comparable to that of propofol, but with fewer effects on hemodynamics. We assessed the Oxygen Reserve Index to verify whether a sedative dose of remimazolam would better preserve oxygenation in the mild hyperoxic range than propofol in sedated patients undergoing diagnostic upper gastrointestinal endoscopy.Patients scheduled for diagnostic upper gastrointestinal endoscopy were enrolled. Patients were randomly assigned to either the remimazolam or propofol groups and received 0.1 mg/kg remimazolam or 0.5 mg/kg propofol, respectively. Bolus injections of either 0.05 mg/kg remimazolam or 0.25 mg/kg propofol were added if required. The primary outcome was the prevalence of oxygen reserve depletion, defined as the Oxygen Reserve Index decreasing to 0.00, and hypoxia defined as peripheral oxygen saturation falling to <94%.Among 69 patients, the incidence of oxygen reserve depletion was significantly higher in the propofol group (65.7% vs. 38.2%, P = 0.022). Hypoxia was frequently observed in the propofol group, whereas none was observed in the remimazolam group (11.4% vs. 0%, P = 0.042). Additional sedative injections were frequently required to complete endoscopy in the propofol group. None of the patients in the remimazolam group required airway interventions. Nausea was frequent in the propofol group in the recovery room.Our results indicate that remimazolam is a safe and useful sedative for upper gastrointestinal endoscopy. [ABSTRACT FROM AUTHOR]

Background: Normal tissue sparing from radiation damage upon ultra-high dose rate irradiation, known as the FLASH effect with an equivalent tumor response, has been widely reported in murine skin models, and translation of this type of radiotherapy to humans has already begun, with skin sparing being a primary outcome expected. Methods: This study reviews the status of the field, focusing on the proposed mechanisms and skin response assays, outlining what has become known in terms of input parameters that might control the magnitude of the FLASH effect. Results: Murine studies have largely focused on acute damage responses, developing over 3–8 weeks, to single doses of FLASH versus conventional dose rate (CDR), suggesting that at dose rates above tens of Gray per second, with a total dose of more than 20 Gy, the FLASH effect is induced. Fractionated delivery appears to be possible, although fraction sizes >17 Gy appear to be needed for sparing efficacy. The interplay between the dose rate and total dose per fraction remains to be fully elucidated. Oxygen is a modulator of efficacy, with both hypoxia and hyperoxia diminishing the effect of FLASH. Measurement of transient changes in oxygen levels is possible and may be a marker of treatment efficacy. Conclusion: Taken together, murine skin data provide important information for translational studies, despite the associated limitations. Studies of later-term sparing effects, as well as studies on pig skin, are needed to take the next step in assessing translational FLASH efficacy. The control of biological factors, such as tissue oxygenation, may be required to understand and control the response. [ABSTRACT FROM AUTHOR]

Introduction: The study aimed to evaluate the effects of Pleurotus Spent Mushroom Substrate (P.SMS) on the rumen microbiota, encompassing bacteria and fungi, as well as their interactions in Hu sheep. Methods: A total of forty-five 3-month-old Hu sheep were randomly assigned to five groups. Each group was fed diets in which whole-plant corn silage (WPCS) was substituted with P.SMS at varying levels: 0% (CON), 5% (PSMS5), 10% (PSMS10), 15% (PSMS15), or 20% (PSMS20). Results: The results indicated that higher proportions of P.SMS during the experimental period might have a detrimental effect on feed utilization efficiency, kidney function, and blood oxygen-carrying capacity. Notably, moderate levels of P.SMS, specifically below 15%, were associated with improvements in rumen NH3-N levels and absorption capacity. The results indicated that (1) PSMS20 exhibited a significantly higher feed-to-gain ratio compared to CON (P < 0.05); (2) PSMS15 showed a significantly higher NH3-N content than CON, PSMS5, and PSMS20. Additionally, PSMS10 and PSMS20 had elevated concentrations of NH3-N compared to CON and PSMS5 (P < 0.05); (3) The length and width of rumen papillae were significantly greater in PSMS20 compared to CON and PSMS5 (P < 0.05); (4) Creatinine levels were significantly higher in PSMS20 than in CON, PSMS5, and PSMS10 (P < 0.05); (5) By the conclusion of the experiment, hemoglobin concentration in PSMS20 showed a significant increase compared to CON (P < 0.05). Furthermore, the addition of P.SMS influenced microorganisms at both the phylum and genus levels: (1) At the phylum level, the prevalence of Patescibacteria was significantly lower in PSMS20 compared to the other groups; (2) PSMS15 exhibited significantly higher relative abundances of Basidiomycota compared to CON and PSMS10, while PSMS20 also demonstrated significantly higher relative abundances compared to CON (P < 0.05); (3) At the genus level, the prevalence of Candidatus_Saccharimonas in PSMS20 was significantly lower than in PSMS5, PSMS10, and PSMS15. Conversely, the prevalence of Phanerochaete in PSMS15 was notably higher than in CON and PSMS10, and it was also significantly elevated in PSMS20 compared to CON (P < 0.05); (4) Correlation analysis indicated no significant correlation between changes in the structure of bacterial and fungal communities. Discussion: Considering these findings, a high percentage of P.SMS negatively impacted feed utilization efficiency, blood oxygen carrying capacity, and kidney function, while a moderate percentage of P.SMS promotes rumen absorption capacity, indicating that feeding 10% P.SMS is optimal. [ABSTRACT FROM AUTHOR]

The prevention of diabetic foot ulcers remains a critical challenge. This study evaluates a smart compression sock designed to address this issue by integrating temperature, plantar pressure, and blood oxygen sensors and monitoring data recorded by these sensors. The smart sock, developed with input from a certified Pedorthist, was tested on 20 healthy adult participants aged 16 to 53. It includes four temperature sensors and pressure sensors at common ulcer sites (first and fifth metatarsal heads, calcaneus, and hallux), and a blood oxygen sensor on the hallux. The sensors are monitored, and their transduced data are collected and stored through an app installed on a personal cell phone. The mobile app interface is user-friendly, providing intuitive navigation and easy access to the sensors' data. Using repeated measures ANOVA and post hoc tests, we analyzed the impact of various physical activities on physiological changes in the foot. The device effectively detected significant variations in blood oxygen, temperature, and pressure across six activities. Statistical analyses revealed significant differences based on activity type and sensor location. These results highlight the smart sock's sensitivity and accuracy, suggesting its potential to prevent diabetic foot ulcers. Further clinical trials are needed to evaluate its efficacy in a larger, more diverse population. [ABSTRACT FROM AUTHOR]

Purpose: Peripheral responses might be important in handcycling, given the involvement of small muscles compared to other exercise modalities. Therefore, the goal of this study was to compare changes in muscle oxygen saturation (∆SmO2) and deoxyhemoglobin level (∆[HHb]) between different efforts and muscles. Methods: Handcyclists participated in a Wingate, a maximal incremental test and a 20-min time-trial (TT). Oxygen uptake (VO2) as well as ∆SmO2, ∆[HHb], deoxygenation and reoxygenation rates in the triceps brachii (TB), biceps brachii (BB), anterior deltoid (AD) and extensor carpi radialis brevis (ER) were measured. Results: ER ∆[HHb]max was 37% greater in the incremental test than in the Wingate (ES = 0.392, P = 0.031). TT mean power (W/kg) was associated with BB ∆SmO2min measured in the incremental test (r = −0.998 [−1.190, −0.806], P = 0.002) and in the Wingate (r = −0.994 [−1.327, −0.661], P = 0.006). MAP (W/kg) was associated with Wingate BB ∆SmO2min (r = −0.983 [−0.999, −0.839], P = 0.003), and Wingate peak (r = 0.649 [0.379, 0.895], P = 0.008) and mean power (W/kg) (r = 0.925 [0.752, 0.972], P = 0.003) was associated with right handgrip force. The strongest physiological predictor for TT performance was BB ∆SmO2min in the incremental test (P = 0.002, r2 = 0.993, SEE 0.016 W/kg), Wingate BB ∆SmO2min for MAP (P = 0.003, r2 = 0.956, SEE 0.058 W/kg) and right handgrip force for Wingate peak power (P = 0.005, r2 = 0.856, SEE 0.551 W/kg). Conclusion: Peripheral aerobic responses (muscle oxygenation) were predictive of handcycling performance. [ABSTRACT FROM AUTHOR]

Purpose: There are many approaches to the quantitative BOLD (qBOLD) technique described in the literature, differing in pulse sequences, MRI parameters and data processing. Thus, in this review, we summarized the acquisition methods, approaches used for oxygenation quantification and clinical populations investigated. Methods: Three databases were systematically searched (Medline, Embase, and Web of Science) for published research that used qBOLD methods for quantification of oxygen metabolism. Data extraction and synthesis were performed by one author and reviewed by a second author. Results: A total of 93 relevant papers were identified. Acquisition strategies were summarized, and oxygenation parameters were found to have been investigated in many pathologies such as steno‐occlusive diseases, stroke, glioma, and multiple sclerosis disease. Conclusion: A summary of qBOLD approaches for oxygenation measurements and applications could help researchers to identify good practice and provide objective information to inform the development of future consensus recommendations. [ABSTRACT FROM AUTHOR]

BACKGROUND Inhibitors of the Na+-coupled glucose transporter SGLT2 (SGLT2i) primarily shift the reabsorption of large amounts of glucose from the kidney's early proximal tubule to downstream tubular segments expressing SGLT1, and the non-reabsorbed glucose is spilled into the urine together with some osmotic diuresis. How can this protect the kidneys and heart from failing as observed in individuals with and without type 2 diabetes? GOAL Mediation analyses identified clinical phenotypes of SGLT2i associated with improved kidney and heart outcome, including a reduction of plasma volume or increase in hematocrit, and lowering of serum urate levels and albuminuria. This review outlines how primary effects of SGLT2i on the early proximal tubule can explain these phenotypes. RESULTS The physiology of tubule-glomerular communication provides the basis for acute lowering of GFR and glomerular capillary pressure, which contributes to lowering of albuminuria but also to long term preservation of GFR, at least in part by reducing kidney cortex oxygen demand. Functional co-regulation of SGLT2 with other sodium and metabolite transporters in the early proximal tubule explains why SGLT2i initially excrete more sodium than expected and are uricosuric, thereby reducing plasma volume and serum urate. Inhibition of SGLT2 reduces early proximal tubule gluco-toxicity and by shifting transport downstream may simulate "systemic hypoxia", and the resulting increase in erythropoiesis, together with the osmotic diuresis, enhances hematocrit and improves blood oxygen delivery. Cardio-renal protection by SGLT2i is also provided by a fasting-like and insulin-sparing metabolic phenotype and, potentially, by off-target effects on the heart and microbiotic formation of uremic toxins. [ABSTRACT FROM AUTHOR]

Purpose: The few previous researches on the impact of calf compression garments (CG) on running performance while assessing physiological and perceptual factors. Therefore, this study investigated how the clothing pressure of two types of Calf CG, CG1 and CG2, affects muscle fatigue and activation during running. Design/methodology/approach: Five healthy amateur runners(three female and two male)were recruited for a 30-min running trial. They wear a Calf CG on their right leg (CG group), but not on their left leg(CON group). After obtaining the clothing pressure of Calf CG on the gastrocnemius lateral head (GL), gastrocnemius medial head (GM) and tibialis anterior(TA) of the right leg, surface electromyography (sEMG)of four muscles of GL, GM, TA and rectus femoris (RF) of the left and right legs were measured during running, and heart rate, cardiopulmonary rate, and human RPE were also measured. Blood bleed oxygen before and after the running trial were measured. The root mean square (RMS) of the characteristic values was selected as an index for the analysis of sEMG signals, and the data were analyzed using statistical and computational methods. Findings: The results showed that the indexes of heart rate, blood oxygen, and RPE were significantly increased, indicating that the subjects had reached the fatigue level. The comparison of mean clothing pressure at GL, GM and TA locations reveals that the TA location consistently exhibits the highest pressure for both types of CG. When wearing CG1, the mean clothing pressure at the GL and GM test points is greater than that of CG2(CG1-GL = 0.2059 kPa > CG2-GL = 0.148 kPa; CG1-GM = 0.1633 kPa > CG2-GM = 0.127 kPa). This is attributed to the double-layered fabric on the sides of CG1, which precisely covers the GL and GM areas, thereby resulting in higher mean clothing pressure at these locations compared to CG2. Conversely, the mean clothing pressure at the TA location for CG1 is lower than that for CG2(CG1-TA = 0.3852 kPa < CG2-TA = 0.426 kPa). The pressure exerted by the CG1 on the lower limb test areas has both positive and negative effects, though neither are statistically significant. The pressure exerted by CG2 alleviates fatigue at the directly affected locations GL and GM, but exerts excessive pressure on TA, resulting in a negative effect. Additionally, CG2 pressure alleviates fatigue at the indirectly affected location RF on the same side. Based on the specific clothing pressure data, it is concluded that when the pressure at the GM location is 0.127 kPa, 30 min of running has a fatigue-relieving effect. However, the pressure should not be excessively high, at 0.1633 kPa it exhibits an insignificant adverse effect. At the TA location, a garment pressure mean between 0.3852 and 0.426 kPa does not alleviate fatigue after 30 min of running, and the negative effect becomes more pronounced as the pressure increases. The pressure exerted by the CG at GL, GM, TA and RF locations shows significant changes from the previous time period during the 15–18 min interval after running. Therefore, in the design of CG, attention should be paid to the changes in clothing pressure effects on muscles during this specific time period. Originality/value: The few previous researches on the impact of calf compression garments (CG) on running performance while assessing physiological and perceptual factors. Therefore, this study investigated how the clothing pressure of two types of Calf CG, CG1 and CG2, affects muscle fatigue and activation during running. [ABSTRACT FROM AUTHOR]

This study investigated the changes in fascicle length (FL), musculotendinous unit (MTU) stiffness, muscle oxygen saturation (SmO2), and muscular performance following a single bout of a combination of static stretching (SS) or dynamic stretching (DS) with foam rolling (FR), SS only, and eccentric exercise (ECC) only in young men with hamstring tightness. Twenty-five men (20.5 ± 1.5 years) participated in a crossover randomized study of the four conditions (DS+FR, SS+FR, SS, and ECC); each session was spaced seven days apart. FL, MTU stiffness during the straight leg raise (SLR), hamstring SmO2, and isometric and eccentric torque were measured before, immediately and 30 min after exercise. Immediately after exercise, the SLR increased significantly by means of 7.4% (d = 1.07), 6% (d = 1.27), 6% (d = 1.10), and 8% (d = 1.04, all p < 0.001) for DS+FR, SS+FR, ECC, and SS, respectively. FL was longer after exercise under all four conditions (p < 0.05). MTU stiffness decreased after ECC (p = 0.038, d = 0.40). SmO2 tended to decrease for ECC (p > 0.05), but it was increased immediately after those three exercises. Hamstring isometric torque was significantly reduced by an average of 6-9%, but eccentric torque changes varied among conditions. In conclusion, substantial and similar immediate increases in hamstring flexibility, coupled with reduced isometric torque following various exercises, were accompanied by condition-specific alterations in fascicle length, MTU stiffness, or SmO2. These findings provide practical insights for acutely enhancing range of motion in individuals with tight hamstrings. [ABSTRACT FROM AUTHOR]

Objective Resting-state functional MRI (rs-fMRI) was used to study the cerebral regional homogeneity (ReHo) in high-altitude population to explore the neural mechanism of brain activity in people with chronic environmental hypoxia. Methods Thirty subjects from the high-altitude and low-altitude (control group) populations underwent Mini-Mental State Examination (MMSE), conventional non-contrast, high-resolution 3-D T1-weighted and blood oxygen level dependent MRI. Based on the Matlab mathematical platform, the DPABI software was used for image processing, and the two-sample t-test was used to compare the two groups of brain regions with local consistency differences. The correlations between ReHo value and blood hemoglobin, oxygen saturation, partial pressure of carbon dioxide, partial pressure of oxygen (PaO2) and platelets were analyzed. Results The MMSE values of the two groups were >29. The results of t-test were corrected by Alphasim and showed that the ReHo values of the Supp_Motor_Area_R (SMA_R, Brodmann area 6) and Supp_Motor_Area_L (SMA_L, Brodmann area 8) brain regions in the high-altitude group were significantly higher than those in the control group (P<0.001). In addition, the ReHo values of Precuneus_R (Brodmann area 29) were significantly lower than that of the control group (P<0.05). The change of SMA_L function was positively correlated with PaO2 (r=0.373, P=0.043). Conclusion The increase of ReHo in bilateral supplementary motor areas and the decrease in the spontaneous activity consistency of the right precuneus neurons may be one of the neural mechanisms for the increase of exercise capacity and the impairment of visual organs and functions after hypoxia in high-altitude populations. [ABSTRACT FROM AUTHOR]

Background: Premature newborns admitted to neonatal intensive care units (NICUs) undergo numerous painful interventions during care and treatment. The purpose of this study was to compare the effects of using sucrose and kangaroo mother care by on selected physiological variables and pain resulting from venipuncture in premature infants admitted to NICUs affiliated with Shiraz University of Medical Sciences. Methods: This clinical trial included premature infants admitted to 2 NICUs. The sample size consisted of 66 neonates, with 22 newborns in each group. Randomization was performed using the block allocation method. Data collection involved a demographic questionnaire, the neonatal infant pain scale, and a pulse oximetry device. Friedman, Kruskal–Wallis, and Dunn's post hoc tests employed for data analysis, with a significance level of P < 0.05. Results: The use of oral sucrose and kangaroo care demonstrated significant differences in breathing rate, heart rate, and average arterial blood oxygen saturation during and after venipuncture (P < 0.05). Oral sucrose was found to be significantly more effective than kangaroo care. Neonates under kangaroo care exhibited more regular heart rates compared to the other group (P < 0.05). The utilization of oral sucrose and kangaroo care had varying effects on the average pain score resulting from venipuncture in premature neonates (P < 0.05). Conclusions: Both methods proved effective in reducing pain and improving physiological variables. However, due to the superior effectiveness of sucrose administration, it is recommended as a cost-effective and easily implementable method in NICUs. Trial registration: Iranian Registry of Clinical Trials IRCT20191215045749N1. (29/03/2020). [ABSTRACT FROM AUTHOR]

The significance of enhancing working conditions for the physical health and performance of workers, particularly female workers, underscores the need for research in this domain and the examination of interventions such as music. Previous studies have yielded diverse outcomes regarding the influence of music on individuals' performance; hence, further research in this area appears imperative. The aim of this study is to explore the impact of music on the cognitive and task performance of female assembly operation operators. This study is an interventional (quasi-experimental) study that involved 81 participants from the female workforce of the medical equipment assembly unit in Isfahan, Iran. The evaluation encompassed task performance, working memory using N-Back test, sustained attention using continues performance test (CPT), degree of sleepiness, and mental fatigue using Flicker Fusion test, along with physiological parameters such as heart rate and blood oxygen level. Participants underwent testing both in the presence of classical music and in a condition without music playback. The provision of background music enhanced the workers' sustained attention and working memory. It led to improved task performance and a reduction in drowsiness. Concerning physiological parameters, it resulted in a slight decrease in heart rate at the end of the work shift and a marginal increase in participants' blood oxygen levels. Background music enhanced working memory (p-value = 0.001), sustained attention (p-value = 0.001), and improved the task performance of workers(p-value = 0.005). Additionally, likely due to increased relaxation, it led to a decrease in heart rate (p-value = 0.001) and an increase in blood oxygen levels (p-value = 0.016). Music also played a role in reducing participants' sleepiness (p-value = 0.001). [ABSTRACT FROM AUTHOR]

Since the milestone contribution by Chen and White in 2007, bioinspired non‐heme bis‐amino‐bis‐pyridylmethyl Fe complexes have been at the forefront of studies related to designing catalytic approaches for direct oxidative functionalization of aliphatic C−H bonds. This, however, has not developed into large‐scale synthetic applications to date. The present concept is aimed at briefly discussing the state‐of‐the‐art of non‐heme Fe catalyzed oxidations of organic molecules with H2O2, the current oxidant of choice of bioinspired oxidation catalysis, mostly focusing on C−H oxidations, and analyzing the peculiarities of their reactivity through the prism of potential applications in fine organic synthesis. [ABSTRACT FROM AUTHOR]

Mild and inexpensive copper‐catalyzed aromatization‐driven ring‐opening amination and oxygenation of spiro dihydroquinazolinones are presented, respectively. These protocols provide facile and atom‐economical access to the aminated and the carbonyl‐containing quinazolin‐4(3H)‐ones in good yields with good functional group compatibility, which are difficult to obtain by conventional methods. Remarkably, a telescoped procedure involving the condensation and the ring‐opening/functionalization for simple cycloalkanone was found to be accessible. Mechanistic studies suggest a radical pathway for this transformation. [ABSTRACT FROM AUTHOR]

Background: Respiratory distress syndrome (RDS) and transient tachypnoea (TTN) are the two commonest neonatal respiratory disorders. The optimal continuous positive airway pressure (CPAP) to treat them is unknown. We aim to clarify the effect of different CPAP levels on lung aeration and gas exchange in patients with RDS and TTN. Methods: Prospective, observational, pragmatic, physiological cohort study. CPAP was sequentially increased from 4 to 6 and 8 cmH2O and backwards, with interposed wash-out periods. Lung aeration was assessed with a validated neonatal lung ultrasound score. Gas exchange was non-invasively evaluated with transcutaneous monitoring. Ultrasound score and PtcO2/FiO2 ratio were the co-primary outcomes. PtcCO2 and other oxygenation metrics were the secondary outcomes. Results: 30 neonates with RDS and 30 with TTN were studied. Each CPAP increment significantly (overall always p < 0.001) improved both lung aeration and oxygenation, but the increase from 6 to 8 cmH2O achieved a small absolute benefit. In RDS patients, the absolute improvements were small and the diagnosis of TTN was significantly associated with greater improvement of lung aeration (β= -1.4 (95%CI: -2.4; -0.3), p = 0.01) and oxygenation (β = 39.6 (95%CI: 4.1; 75.1), p = 0.029). Aeration improved in 16 (53.3%) and 27 (90%) patients in the RDS and TTN groups, respectively (p = 0.034). Lung aeration showed significant hysteresis in TTN patients. Secondary outcomes gave similar results. Conclusions: Increasing CPAP from 4 to 8 cmH2O improves ultrasound-assessed lung aeration and oxygenation in RDS and TTN. The absolute improvements are small when CPAP is beyond 6 cmH2O or for RDS patients. [ABSTRACT FROM AUTHOR]

Skeletal editing of single-atom insertion to basic chemicals has been demonstrated as an efficient strategy for the discovery of structurally diversified compounds. Previous endeavors in skeletal editing have successfully facilitated the insertion of boron, nitrogen, and carbon atoms. Given the prevalence of oxygen atoms in biologically active molecules, the direct oxygenation of C-C bonds through single-oxygen-atom insertion like Baeyer-Villiger reaction is of particular significance. Herein, we present an approach for the skeletal modification of styrenes using O2 via oxygen insertion, resulting in the formation of aryl ether frameworks under mild reaction conditions. The broad functional-group tolerance and the excellent chemo- and regioselectivity are demonstrated in this protocol. A preliminary mechanistic study indicates the potential involvement of 1,2-aryl radical migration in this reaction. The direct oxygenation of C–C bonds through single-oxygen-atom insertion like the Baeyer-Villiger reaction is of particular significance. Herein, the authors present an approach for the skeletal modification of styrene using O2 via oxygen insertion, resulting in the formation of aryl ether frameworks under mild reaction conditions. [ABSTRACT FROM AUTHOR]

Background: The global effort to cure COVID-19 is still ongoing. Thus, a prospective, block-balanced, open-label, randomized controlled trial was conducted to evaluate how Tenofovir Alafenamide Fumarate affects hospitalized COVID-19 patients' outcomes. Methods: The intervention and control groups of 60 hospitalized COVID-19 patients were randomly allocated. Along with normal medication, the intervention group received 25 mg of tenofovir orally daily for seven days. The control group got normal therapy, including remdesivir and corticosteroids. ICU hospitalization duration, laboratory data, fever, dyspnea, arterial blood oxygen saturation with and without an oxygen face mask, mechanical ventilation, and mortality were the outcomes. Results: Sixty of 236 eligible patients between September 2020 and February 2021 were enrolled. The intervention group had a mean age (±SD) of 61.33 (±13.09) years and the control group 60.03 (±18.03). Sixteen (53.3%) intervention patients and 15 (50.0%) control patients were males. The intervention group had fewer mechanical ventilation and ICU days. Tenofovir Alafenamide Fumarate did not improve fever, dyspnea, oxygen saturation with or without a face mask or nasal cannula, or laboratory data including WBC, ESR, CRP, AST, ALT, AlkP, total and direct bilirubin, in COVID-19 patients. Conclusion: According to this pilot trial, Tenofovir Alafenamide Fumarate, along with conventional treatment, significantly reduced mechanical ventilation and ICU stay in COVID-19 patients. Further thorough research is necessary to verify this conclusion. [ABSTRACT FROM AUTHOR]

This paper presents the development of a vital sign monitoring system designed specifically for professional athletes, with a focus on runners. The system aims to enhance athletic performance and mitigate health risks associated with intense training regimens. It comprises a wearable glove that monitors key physiological parameters such as heart rate, blood oxygen saturation (SpO2), body temperature, and gyroscope data used to calculate linear speed, among other relevant metrics. Additionally, environmental variables, including ambient temperature, are tracked. To ensure accuracy, the system incorporates an onboard filtering algorithm to minimize false positives, allowing for timely intervention during instances of physiological abnormalities. The study demonstrates the system's potential to optimize performance and protect athlete well-being by facilitating real-time adjustments to training intensity and duration. The experimental results show that the system adheres to the classical "220-age" formula for calculating maximum heart rate, responds promptly to predefined thresholds, and outperforms a moving average filter in noise reduction, with the Gaussian filter delivering superior performance. [ABSTRACT FROM AUTHOR]

Background: Imaging examination of cerebral blood flow (CBF), oxygen extraction fraction (OEF), and metabolic rate of oxygen is crucial for understanding the normal functioning and pathophysiology of the brain. A recently developed method estimates the appearance time of cerebral blood (ATB) pixel-wise from the imaging examination of CBF alone. In this study, we aimed to test the potential of ATB as an indicator of OEF. Results: We retrospectively reviewed patients (n = 62) with suspected cerebrovascular disorders including steno-occlusive disease who underwent positron emission tomography (PET) with 15O-labelled tracers. Regarding the generated OEF and ATB images, a visual assessment was performed to test the consistency of the elevated OEF and delayed ATB. The OEF and ATB values and the absolute differences between their ipsilateral and contralateral sides were extracted and obtained for the entire hemisphere and the middle, anterior, and posterior cerebral arterial regions. Consistency was observed in 52 PET scans (83.9%) in visual assessment. The OEF and ATB values were moderately correlated (r = 0.553, p < 0.001), and the differences between their ipsilateral and contralateral sides were weakly correlated (r = 0.276, p < 0.001). Conclusion: Our results indicate the potential of ATB as an indicator of OEF. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to characterize blood oxygen level-dependent (BOLD) effects in proton magnetic resonance (1H-MR) spectra obtained during optogenetic activation of the rat forelimb cortex to correct and estimate the accurate changes in metabolite concentration. Methods: For a more comprehensive understanding of BOLD effects detected with functional magnetic resonance spectroscopy (fMRS) and to optimize the correction method, a 1Hz line-narrowing effect was simulated. Then, proton functional magnetic resonance spectroscopy (1H-fMRS) data acquired using stimulated echo acquisition mode (STEAM) at 9.4T in rats (n = 8) upon optogenetic stimulation of the primary somatosensory cortex were utilized. The data were analyzed using MATLAB routines and LCModel. Uncorrected and corrected 1H-MR spectra from the simulated and in vivo data were quantified and compared. BOLD-corrected difference spectra were also calculated and analyzed. Additionally, the effects of stimulated and non-stimulated water on the quantification of metabolite concentration swere investigated. Results: Significant mean increases in water and N-acetylaspartate (NAA) peak heights (+1.1% and +4.5%, respectively) were found to be accompanied by decreased linewidths (-0.5Hz and -2.8%) upon optogenetic stimulation. These estimates were used for further defining an accurate line-broadening (lb) factor. The usage of a non-data-driven lb introduced false-positive errors in the metabolite concentration change estimates, thereby altering the specificity of the findings. The water andmetabolite BOLD contributions were separated using different water scalings within LCModel. Conclusion: The linewidth-matching procedure using a precise lb factor remains the most effective approach for accurately quantifying small (±0.3 µmol/g) metabolic changes in 1H-fMRS studies. A simple and preliminary compartmentation of BOLD effects was proposed, but it will require validation. [ABSTRACT FROM AUTHOR]

Reported herein is the first total synthesis of the poly‐pseudoindoxyl natural product baphicacanthcusine A. The synthesis leverages the oxidative rearrangement of indoles to pseudoindoxyls to install vicinal pseudoindoxyl heterocycles in a diastereoselective manner. Key steps include an acid‐mediated cyclization/indole transposition, two diastereoselective oxidative ring contractions, and a site‐selective C−H oxygenation. The synthesis of the oxidation precursors was guided by recognition of an element of hidden symmetry. This work provides a foundation for the chemical synthesis of other poly‐pseudoindoxyl alkaloids. [ABSTRACT FROM AUTHOR]

Background: Oxygenation index (OI) is associated with severity of newborn pulmonary hypertension (PH) in congenital diaphragmatic hernia (CDH). Higher OI may indicate worst degree(s) of PH. Objectives: This study reports OI dynamic(s) over the first 72 h of life and its correlation with (1) perioperative morbidity and (2) CDH mortality. Methods: Medical records of inborn CDH babies during 2002–2022 were examined. OI on Days (s) 1–3 and perioperative OI trends were recorded. Operation (primary vs patch repair) and survival rates (%) were studied. Results: Fifty-five CDH newborns (54.5% male: 45.5% female)—mean birth GA 37.5 ± 2.7 wks. had a mean birth weight 2813 ± 684 g with prenatal diagnosis in 32.7% cases. 52/55 (94.5%) were intubated at birth and HFOV deployed in 29 (55.8%). Those requiring HFOV had higher OI on DOL1 (24.8 ± 17 vs 10.3 ± 11.5; p < 0.05), DOL 2 (26.3 ± 22.9 vs 6.7 ± 12.1; p < 0.05) and DOL 3 (21.9 ± 33.8 vs 5.5 ± 9.3; p = 0.04). Operation was undertaken in 36/55 (65.5%). Preoperative mortality group had significant higher OI on DOL 2 (42.1 ± 21.0 vs 14.9 ± 9.3; p = 0.04). CDH defects were—Type A N = 27 (75%), Type B N = 7 (19.4%) and Type C N = 2 (5.6%). Overall mortality was 40% (22/55). Statistically significant OI trends were recorded in non-survival vs. survival groups on DOL 1 (31.6 ± 16.8. vs 10.5 ± 9.0; p < 0.05, DOL 2 (38.1 ± 21.9 vs 6.3 ± 7.1; p < 0.05), and DOL 3 (38.8 ± 39.4; p = 0.012). Conclusions: OI dynamics are highly predictive for accurate monitoring of CDH cardiorespiratory physiology and crucially may guide ventilatory management as well as timing of surgery. [ABSTRACT FROM AUTHOR]

Background and Aims: Because bronchoscopy is an invasive procedure, sedatives and analgesics are commonly administered, which may suppress the patient's spontaneous breathing and can lead to hypoventilation and hypoxemia. Few reports exist on the dynamic monitoring of oxygenation and ventilation during bronchoscopy. This study aimed to prospectively monitor and evaluate oxygenation and ventilation during bronchoscopy using transcutaneous arterial blood oxygen saturation and carbon dioxide. Methods: We included patients who required pathological diagnosis using fluoroscopic bronchoscopy at our hospital between March 2021 and April 2022. Midazolam was intravenously administered to all patients as a sedative during bronchoscopy, and fentanyl was administered in addition to midazolam when necessary. A transcutaneous blood gas monitor was used to measure dynamic changes, including arterial blood partial pressure of carbon dioxide (tcPCO2), transcutaneous arterial blood oxygen saturation (SpO2), pulse rate, and perfusion index during bronchoscopy. Quantitative data of tcPCO2 and SpO2 were presented as mean ± standard deviation (SD) (min–max), while the quantitative data of midazolam plus fentanyl and midazolam alone were compared. Similarly, data on sex, smoking history, and body mass index were compared. Subgroup comparisons of the difference (Δ value) between baseline tcPCO2 at the beginning of bronchoscopy and the maximum value of tcPCO2 during the examination were performed. Results: Of the 117 included cases, consecutive measurements were performed in 113 cases, with a success rate of 96.6%. Transbronchial lung biopsy was performed in 100 cases, whereas transbronchial lung cryobiopsy was performed in 17 cases. Midazolam and fentanyl were used as anesthetics during bronchoscopy in 46 cases, whereas midazolam alone was used in 67 cases. The median Δ value in the midazolam plus fentanyl and midazolam alone groups was 8.10 and 4.00 mmHg, respectively, indicating a significant difference of p < 0.005. The mean ± standard deviation of tcPCO2 in the midazolam plus fentanyl and midazolam alone groups was 44.8 ± 7.83 and 40.6 ± 4.10 mmHg, respectively. The SpO2 in the midazolam plus fentanyl and midazolam alone groups was 94.4 ± 3.37 and 96.2 ± 2.61%, respectively, with a larger SD and greater variability in the midazolam plus fentanyl group. Conclusion: A transcutaneous blood gas monitor is non-invasive and can easily measure the dynamic transition of CO2. Furthermore, tcPCO2 can be used to evaluate the ventilatory status during bronchoscopy easily. A transcutaneous blood gas monitor may be useful to observe regarding respiratory depression during bronchoscopy, particularly when analgesics are used. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effect of alfentanil in combination with propofol in painless gastrointestinal endoscopy (PGE) in elderly patients. Methods: This was a retrospective analysis of data from 200 elderly patients who underwent PGE at The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou, China from June 2021 to December 2022. The patients were divided into study (n = 108) and control groups (n = 92). The study group received anesthesia with alfentanil (10 µg/kg) and propofol (1 - 2 mg/kg), while the control group was anesthetized with sufentanil (0.1 µg/kg) combined with propofol (1 - 2 mg/kg). Results: Study group consumed significantly less propofol compared to control group (p < 0.05). There were no significant differences in baseline values of mean arterial pressure (MAP), blood oxygen saturation (BOS), and heart rate (HR) between the two groups (p > 0.05). However, during the examination, the control group showed significantly lower mean values of MAP, BOS, and HR compared to study group (p < 0.05). Additionally, study group experienced significantly shorter recovery time from anesthesia, time to recovery of consciousness, and time to orientation recovery compared to control group (p < 0.05). The incidence of patients rated with excellent or good anesthetic effects was significantly higher in study group compared to control group (p < 0.05). Conclusion: Alfentanil in combination with propofol offers stable vital signs and superior anesthetic effect in elderly patients undergoing PGE, with fewer adverse reactions compared to sufentanil and propofol combination. Applicability of these findings requires further validation with more data. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Early and timely closure of secondary tracheoesophageal fistula (TEF) is crucial for critically ill patients. For those requiring invasive mechanical ventilation, the Amplatzer Duct Occluder II (ADO II) can be used as an emergency therapeutic option to rapidly close secondary TEF, providing opportunities for subsequent treatments. Secondary tracheoesophageal fistula (TEF) is a life‐threatening condition characterized by high mortality, high recurrence rates, and multiple complications. Reports on the management of secondary TEF in critically ill patients are limited due to the challenges in treatment and the lack of suitable therapeutic options. We report a case of secondary TEF in a 69‐year‐old male diagnosed with severe pneumonia, whose condition deteriorated rapidly following the onset of TEF. Despite invasive mechanical ventilation, maintaining blood oxygen saturation above 80% was unachievable due to the TEF. Bedside bronchoscopy revealed expansion TEF expansion caused by gastrointestinal fluid reflux and respiratory machine pressure. The TEF was urgently closed using an ADO II device during invasive mechanical ventilation to prevent further deterioration. After the patient's condition stabilized, the ADO II was replaced with a Y‐shaped tracheal membrane‐covered stent for further TEF management. The patient's condition improved, meeting the criteria for liberation from invasive mechanical ventilation, and bedside chest X‐rays revealed a gradual resolution of pulmonary inflammation. Selecting appropriate treatment modalities for early and timely closure of secondary TEF is crucial for critically ill patients. ADO II can serve as a rescue therapy to achieve rapid closure of secondary TEF in critically ill patients requiring invasive mechanical ventilation support, providing opportunities and time for subsequent treatment. [ABSTRACT FROM AUTHOR]

Total dissolved gas supersaturation (TDGS) occurs when air mixes with water under pressure, which can be caused by features such as hydroelectric dams and waterfalls. Total dissolved gas supersaturation can cause harmful bubbles to grow in the tissues of aquatic animals, a condition known as gas bubble trauma (GBT). As gills are the primary gas exchange surface for most fish, it is through the gills that elevated total dissolved gases enter the blood and tissues of a fish. We describe the role of the gills in admitting TDGS into the body and discuss potential effects of bubbles in the gills on blood oxygen and carbon dioxide diffusion, blood ion and pH homeostasis, and nitrogenous waste excretion, as well as downstream effects on aerobic swimming performance. [ABSTRACT FROM AUTHOR]

Ensuring the appropriate dissolved oxygen concentration in the aquaculture water is crucial to the healthy growth of cultured fish. In order to meet the oxygen demand requirements for high-density aquaculture with super large water capacity of aquaculture vessel. According to the double membrane theory and Fick's law, as well as the testing standards for the oxygenation capacity of aerators, a speece cone size model was designed and its oxygen enhancement performance tests were conducted. The experiment results show that the dissolved oxygen concentration at the outlet of the speece cone reaches 40 mg/L, and the supersaturated dissolved oxygen is close to 400%, achieving ultra-high saturation dissolved oxygen. Under the conditions of an oxygen intake rate of 7.6 m³/h and an oxygen cone operating pressure of 0.07-0.25 MPa, the oxygenation capacity is not significantly affected by the operating pressure. However, the optimal intake rate range is significantly affected by the operating pressure. The higher the operating pressure, the less likely it is to form large bubbles on the water surface when the oxygen intake rate increases, thus maintaining a higher oxygen utilization rate. When the oxygen intake is greater than 6.5 m³/h and the operating pressure is between 0.07 MPa and 0.25 MPa, each aquaculture cabin is equipped with one speece cone of this structural size to meet the oxygen demand of the aquaculture cabin. The oxygenation capacity of this speece cone is significantly higher than other oxygenation devices, and its power efficiency is also higher than most oxygenation devices, which is suitable for oxygenation of aquaculture vessel. This study provides basic data for the engineering design and stable and efficient operation of the oxygen enrichment equipment of aquaculture vessel. [ABSTRACT FROM AUTHOR]

Background: Inhaled nitric oxide (iNO) can improve oxygenation in acute respiratory syndrome (ARDS), has anti-inflammatory and antithrombotic effects, and can inhibit coronavirus- replication. The study aim was to investigate the impact of iNO in COVID-19 associated ARDS (CARDS) on oxygenation, the length of mechanical ventilation (MV), the level of inflammatory markers and the rate of thrombotic events during ICU stay. Methods: This was a retrospective, observational, monocentric study analyzing the effect of INO (15 parts per million) vs. non-iNO in adult ventilated CARDS patients on oxygenation, the level of inflammatory markers, and the rate of thrombotic events during ICU stay. Within the iNO group, the impact on gas exchange was assessed by comparing arterial blood gas results obtained at different time points. Results: Overall, 19/56 patients were treated with iNO, with no difference regarding sex, age, body mass index, and SOFA-/APACHE II- score between the iNO and non-iNO groups. iNO improved oxygenation in iNO-responders (7/19) and had no impact on inflammatory markers or the rate of thrombotic events but was associated with an increased MV length. Conclusions: iNO was able to improve oxygenation in CARDS in iNO-responders but did not show an impact on inflammatory markers or the rate of thrombotic events, while it was associated with an increased MV length. [ABSTRACT FROM AUTHOR]

Functional magnetic resonance imaging (fMRI) is currently one of the most popular technologies for measuring brain activity in both research and clinical contexts. However, clinical constraints often result in short fMRI scan durations, limiting the diagnostic performance for brain disorders. To address this limitation, we developed an end‐to‐end frequency‐specific dual‐attention‐based adversarial network (FDAA‐Net) to extend the time series of existing blood oxygen level‐dependent (BOLD) data, enhancing their diagnostic utility. Our approach leverages the frequency‐dependent nature of fMRI signals using variational mode decomposition (VMD), which adaptively tracks brain activity across different frequency bands. We integrated the generative adversarial network (GAN) with a spatial–temporal attention mechanism to fully capture relationships among spatially distributed brain regions and temporally continuous time windows. We also introduced a novel loss function to estimate the upward and downward trends of each frequency component. We validated FDAA‐Net on the Human Connectome Project (HCP) database by comparing the original and predicted time series of brain regions in the default mode network (DMN), a key network activated during rest. FDAA‐Net effectively overcame linear frequency‐specific challenges and outperformed other popular prediction models. Test–retest reliability experiments demonstrated high consistency between the functional connectivity of predicted outcomes and targets. Furthermore, we examined the clinical applicability of FDAA‐Net using short‐term fMRI data from individuals with autism spectrum disorder (ASD) and major depressive disorder (MDD). The model achieved a maximum predicted sequence length of 40% of the original scan durations. The prolonged time series improved diagnostic performance by 8.0% for ASD and 11.3% for MDD compared with the original sequences. These findings highlight the potential of fMRI time series prediction to enhance diagnostic power of brain disorders in short fMRI scans. [ABSTRACT FROM AUTHOR]

Background The hemodynamics of prefrontal cortex (PFC) oxygenation are regulated by numerous processes operating over multiple temporal scales, producing complex patterns in its output fluctuations. Age may alter this multiscale regulation of PFC oxygenation, leading to diminished physiologic complexity of this important regulatory process. We aimed to characterize the effects of age on such complexity and its relationship to performance of an executive n -back task. Methods Twenty-four younger (aged 28 ± 3 years) and 27 older (aged 78 ± 6 years) adults completed this study. Continuous oxygenation (HbO2) and deoxygenation (HHb) signals of PFC were recorded using functional near-infrared spectroscopy (fNIRS) while participants stood and watched a blank screen (blank), clicked a mouse when an X appeared (IdX), or when a letter was repeated from "2-back" in a sequence shown on a screen (2-back). We used multiscale entropy to quantify the HbO2 and HHb complexity of fNIRS signals. Results Older adults exhibited lower HbO2 and HHb complexity compared to younger adults, regardless of task (p  = .0005–.002). Both groups exhibited greater complexity during the IdX and 2-back than blank task (p  = .02–.04). Across all participants, those with greater HbO2 and/or HHb complexity during the blank task exhibited faster IdX and 2-back reaction time (β = −0.56 to −0.6, p  = .009–.02). Those demonstrating greater increase in HbO2 and/or HHb complexity from IdX to 2-back task had lower percent increase in reaction time from IdX to 2-back task (β = −0.41 to −0.37, p  = .005–.01). Conclusions The complexity of fNIRS-measured PFC oxygenation fluctuations may capture the influence of aging on the regulation of prefrontal hemodynamics involved in executive-function-based task performance. [ABSTRACT FROM AUTHOR]

The regeneration of hypoxia‐impaired chronic tissue defects has long been challenging, mainly due to the inefficiency of oxygenation and the limited biological activity of existing oxygen delivery systems in regulating dynamic tissue regeneration process. Herein, a novel polyphenol‐copper coordination strategy to fabricate bioactive superoxide dismutase‐catalase self‐cascade nanozymes (SalB‐CuNCs) is reported, which can serve as an in situ oxygenator and induce angiogenesis simultaneously. The copper‐phenolic hydroxyl coordination structure in SalB‐CuNCs plays a critical role in promoting the enzyme‐like cascade reaction via catechol‐mediated Cu valence state transition and substrate capture mechanism. Furthermore, after incorporating SalB‐CuNCs into a Schiff base hydrogel (COC@SalB‐Cu), the resulting system exhibits outstanding antioxidant and robust oxygenation effect in mitigating the hypoxic microenvironment. Benefiting from the intrinsic angiogenic activity of SalB and copper, COC@SalB‐Cu hydrogel can induce a more complete tube formation by up‐regulating the expression level of vascular endothelial growth factor (VEGF), platelet‐endothelial cell adhesion molecule‐1 (CD31), and endothelial nitric oxide synthase (eNOS). In vivo experiments further demonstrate that the COC@SalB‐Cu hydrogel can significantly restore the oxygen and blood supply, leading to fast tissue regeneration. The present strategy holds enormous promise for the treatment of hypoxia‐related chronic tissue defects and vascular injury in the field of regenerative medicine. [ABSTRACT FROM AUTHOR]

Exogenous ketone supplements are a potential augmentation strategy for cognitive resilience during acute hypoxic exposure due to their capacity to attenuate the decline in oxygen (O2) availability, and by providing an alternative substrate for cerebral metabolism. Utilizing a single‐blind randomized crossover design, 16 male military personnel (age, 25.3 ± 2.4 year, body mass, 86.2 ± 9.3 kg) performed tests of cognitive performance at rest in three environments: room air (baseline), normoxia (20 min; 0 m; 20.9% O2) and hypoxia (20 min; 6096 m, 9.7% O2) using a reduced O2 breathing device (ROBD). (R)‐3‐Hydroxybutyl (R)‐3‐hydroxybutyrate (R‐BD R‐βHB) ketone monoester (KME; 650 mg/kg, split dose given at 30 min prior to each exposure) or taste‐matched placebo (PLA) was ingested prior to normoxia and hypoxic exposure. Blood R‐βHB and glucose concentrations, cognitive performance and O2 saturation (SpO2${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$) were collected throughout. KME ingestion increased blood R‐βHB concentration, which was rapid and sustained (>4 mM 30 min post; P < 0.001) and accompanied by lower blood glucose concentration (∼20 mg/dL; P < 0.01) compared to PLA. Declines in cognitive performance during hypoxic exposure, assessed as cognitive efficiency during a Defense Automated Neurobehavioral Assessment (DANA) code substitution task, were attenuated with KME leading to 6.8 (95% CL: 1.0, 12.6) more correct responses per minute compared to PLA (P = 0.018). The decline in SpO2${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$ during hypoxic exposure was attenuated (6.40% SpO2${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$; 95% CL: 0.04, 12.75; P = 0.049) in KME compared to PLA (KME, 76.8 ± 6.4% SpO2${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$; PLA, 70.4 ± 7.4% SpO2${{S}_{{\mathrm{p}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$). Acute ingestion of KME attenuated the decline in cognitive performance during acute severe hypoxic exposure, which coincided with attenuation of declines in O2 saturation. What is the central question of this study?Can exogenous ketosis act as a countermeasure to declines in blood oxygen saturation and cognitive performance during acute severe hypoxic exposure at rest?What is the main finding and its importance?Acute exogenous ketosis via ingestion of a drink containing the (R)‐3‐hydroxybutyl (R)‐3‐hydroxybutyrate ketone monoester prior to acute severe hypoxic exposure attenuated hypoxia‐induced declines in blood oxygen saturation and cognitive performance at rest. [ABSTRACT FROM AUTHOR]

Acute ingestion of exogenous ketone supplements in the form of a (R)‐3‐hydroxybutyl (R)‐3‐hydroxybutyrate (R‐BD R‐βHB) ketone monoester (KME) can attenuate declines in oxygen availability during hypoxic exposure and might impact cognitive performance at rest and in response to moderate‐intensity exercise. In a single‐blind randomized crossover design, 16 males performed assessments of cognitive performance before and during hypoxic exposure with moderate exercise [2 × 20 min weighted ruck (∼22 kg) at 3.2 km/h at 10% incline] in a normobaric altitude chamber (4572 m, 11.8% O2). The R‐BD R‐βHB KME (573 mg/kg) or a calorie‐ and taste‐matched placebo (∼50 g maltodextrin) were co‐ingested with 40 g of dextrose before exposure to hypoxia. The R‐βHB concentrations were rapidly elevated and sustained (>3 mM; P < 0.001) by KME. The decline in oxygen saturation during hypoxic exposure was attenuated in KME conditions by 2.4%–4.2% (P < 0.05) compared with placebo. Outcomes of cognitive performance tasks, in the form of the Defense Automated Neurobehavioral Assessment (DANA) code substitution task, the Stroop color and word task, and a shooting simulation, did not differ between trials before and during hypoxic exposure. These data suggest that the acute exogenous ketosis induced by KME ingestion can attenuate declining blood oxygen saturation during acute hypoxic exposure both at rest and during moderate‐intensity exercise, but this did not translate into differences in cognitive performance before or after exercise in the conditions investigated. What is the central question of this study?Can exogenous ketosis act as a countermeasure to declines in blood oxygen saturation and cognitive performance during acute hypoxic exposure while performing a weighted ruck exercise?What is the main finding and its importance?Acute exogenous ketosis via ingestion of a drink containing the (R)‐3‐hydroxybutyl (R)‐3‐hydroxybutyrate ketone monoester prior to acute hypoxic exposure attenuated hypoxia‐induced declines in blood oxygen saturation but had no effect on cognitive performance during exercise. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusionThis study examines the therapeutic potential of monotropein (Mon) in a rat model of acute pulmonary embolism (APE), aiming to elucidate its mechanistic role and provide new insights for APE treatment.Thirty Sprague Dawley (SD) rats were randomly assigned to five groups (n = 6 per group): sham, Mon (40 mg/kg), APE, APE + 20 mg/kg Mon, and APE + 40 mg/kg Mon. APE was induced via autologous thrombus infusion in all groups except sham and Mon-only groups. We assessed blood gas parameters, lung wet/dry weight (W/D) ratio, and oxidative stress markers. Additionally, excised lung tissues underwent evaluation for serum inflammatory factors via ELISA, apoptotic cells via TUNEL assay, and protein expression via Western blot.Compared to the sham group, APE-induced rats exhibited significantly elevated blood oxygen levels and increased pro-inflammatory factors, including interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, and IL-8. Mon treatment effectively mitigated these APE-induced changes, reducing blood oxygen concentration and downregulating IL-1β and TNF-α levels. Furthermore, Mon demonstrated anti-apoptotic effects by decreasing cleaved caspase-3 and Bax protein levels while upregulating Bcl-2 expression. Mon also suppressed nuclear factor-κB (NF-κB) activation by inhibiting the phosphorylation levels of p65/RelA and IκBα proteins, while the total protein level of IκBα was increased with Mon treatment.Mon effectively ameliorated lung tissue injury in APE rats by inhibiting apoptosis, attenuating inflammatory responses, and alleviating oxidative stress. These beneficial effects appear to be mediated through modulation of the NF-κB pathway, suggesting Mon as a promising therapeutic candidate for APE treatment. [ABSTRACT FROM AUTHOR]

Lung function has never been assessed during kangaroo mother care (KMC) in preterm infants. We measured lung (rSO2L) and cerebral (rSO2C) oxygenation by near-infrared spectroscopy (NIRS) in infants born at less than 32 weeks of gestation or weighing ≤ 1500 g during KMC. rSO2L, rSO2C, and pulmonary (FOEL) and cerebral (FOEC) tissue oxygen extraction fraction were measured in 20 preterm infants before, during, and after a 2-h period of KMC at a mean postnatal age of 36 ± 21 days of life. We found that rSO2L, rSO2C, FOEL, and FOEC did not change in our patients. After 120 min of KMC, rSO2L was lower (71.3 ± 1.4 vs. 76.7 ± 4.6%; P = 0.012) in infants with BPD (n = 6; 30%) than in infants without BPD (n = 14 = 60%), while FOEL was higher (0.26 ± 0.02 vs. 0.20 ± 0.05; P = 0.012). Conclusion: Cerebral and lung oxygenation did not change in preterm infants during KMC. A transient decrease in lung oxygenation was offset by the increase in oxygen extraction, but these changes were clinically insignificant. These results confirm the safety of KMC in preterm infants who are in stable clinical conditions. What is Known • Kangaroo mother care (KMC) is widely used to improve the care of preterm newborns since it improves their outcome. • KMC is safe as patients' vital parameters, are not negatively affected, but lung function has never been directly assessed. What is New • Cerebral and lung oxygenation measured by near-infrared spectroscopy did not change during KMC. • A transient decrease in lung oxygenation compensated for by the increase in oxygen extraction occurred only in infants with BPD, but these changes were clinically insignificant. [ABSTRACT FROM AUTHOR]

BOLD signal variability (SDBOLD) has emerged as a unique measure of the adaptive properties of neural systems that facilitate fast, stable responding, based on claims that SDBOLD is independent of mean BOLD signal (meanBOLD) and is a powerful predictor of behavioral performance. We challenge these two claims. First, the apparent independence of SDBOLD and meanBOLD may reflect the presence of deactivations; we hypothesize that although SDBOLD may not be related to raw meanBOLD, it will be linearly related to "absolute" meanBOLD. Second, the observed relationship between SDBOLD and performance may be an artifact of using fixed-length trials longer than RTs. Such designs provide opportunities to toggle between on- and off-task states, and fast responders likely engage in more frequent state-switching, thereby artificially elevating SDBOLD. We hypothesize that SDBOLD will be higher and more strongly related to performance when using such fixed-length trials relative to self-paced trials that terminate upon a response. We test these two hypotheses in an fMRI study using blocks of fixed-length or self-paced trials. Results confirmed both hypotheses: (1) SDBOLD was robustly related with absolute meanBOLD, and (2) toggling between on- and off-task states during fixed-length trials reliably contributed to SDBOLD. Together, these findings suggest that a reappraisal of the functional significance of SDBOLD as a unique marker of cognitive performance is warranted. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate how the cumulative expulsion interval, litter size, and birth order influence the characteristics of newborn piglets from hyperprolific sows, as well as their intake of colostrum. Analysis was conducted on the temporal aspects of parturition in 254 sows, including 3920 piglets. Newborn piglet characteristics examined encompassed delivery time, birth order, birth status, umbilical cord rupture, meconium staining, delivery ease, birth weight, blood oxygen saturation, and heart rate. From the raw data, colostrum intake, birth interval, and cumulative birth interval of each piglet were computed. Piglets were sorted based on the cumulative expulsion interval into nine categories: 0–30, 31–60, 61–90, 91–120, 121–150, 151–180, 181–210, 211–240, and >240 min. Litter sizes were categorized into three groups: 10–13, 14–17, and ≥18 piglets per litter. The birth-order ranking referred to the piglet's position within a litter and was categorized into four quartiles: 1, 2, 3, and 4. On average, the expulsion interval, cumulative expulsion interval, and colostrum consumption were 14.8 ± 21.8 min, 138.6 ± 155.7 min, and 407.6 ± 162.1 g, respectively. In litters with ≥18 piglets, the percentage of piglets with inadequate colostrum intake (<300 g) was higher compared to litters with 10–13 piglets (33.1 % vs. 12.9 %, P < 0.001) and 14–17 piglets (23.9 %, P < 0.001). The occurrence of stillbirths in the fourth quartile of the litter was higher than in the first (16.0 % vs. 2.2 %, P < 0.001), second (4.0 %, P < 0.001), and third (7.8 %, P < 0.001) quartiles. Among litters with ≥18 piglets, those born in the third quartile exhibited lower colostrum consumption compared to those born in the first quartile (346.0 ± 9.9 vs. 391.4 ± 8.6 g, P = 0.028). Colostrum intake decreased with longer cumulative expulsion intervals, evident from a notable decline starting at 90 min post-farrowing compared to piglets born within the first 30 min (P = 0.004). Interestingly, colostrum consumption exhibited a negative correlation with the cumulative expulsion interval (P < 0.001), but not with individual piglet expulsion intervals (P = 0.460). Piglets born with meconium staining were most prevalent among those with a cumulative expulsion interval of >240 min. In summary, both the cumulative expulsion interval and birth-order ranking significantly impact the physiological characteristics of newborn piglets and their colostrum intake. Colostrum consumption decreases and newborn piglet characteristics change with higher cumulative expulsion intervals. Identifying piglets at high risk of hypoxia and implementing appropriate treatments and management strategies within an optimal timeframe could aid pig producers in reducing pre-weaning mortality among piglets born to hyperprolific sows. • The analysis was conducted on the parturition timing of 3920 piglets. • Colostrum intake decreased with longer cumulative expulsion intervals. • Meconium staining was most prevalent in piglets with expulsion intervals of >240 min. • Birth assistance in litters of ≥18 piglets was lower than in smaller litters. • The incidence of umbilical rupture in the fourth quartile was higher than in the first. [ABSTRACT FROM AUTHOR]

Cerebral mitochondrial and hemodynamic abnormalities have been implicated in Bipolar Disorder pathophysiology, likely contributing to neurometabolic vulnerability–leading to worsen clinical outcomes and mood instability. To investigate neurometabolic vulnerability in patients with BD, we combined multi-modal quantitative MRI assessment of cerebral oxygenation with acute administration of Methylene Blue, a neurometabolic/hemodynamic modulator acting on cerebral mitochondria. Fifteen euthymic patients with chronic BD-type 1, and fifteen age/gender-matched healthy controls underwent two separate MRI sessions in a single-blinded randomized cross-over design, each after intravenous infusion of either MB (0.5 mg/kg) or placebo. MRI-based measures of Cerebral Blood Flow and Oxygen Extraction Fraction were integrated to compute Cerebral Metabolic Rate of Oxygen in Frontal Lobe, Anterior Cingulate, and Hippocampus–implicated in BD neurometabolic pathophysiology. Inter-daily variation in mood rating was used to assess mood instability. A decrease in global CBF and CMRO 2 was observed after acutely administrating MB to all participants. Greater regional CMRO 2 reductions were observed after MB, in patients compared to controls in FL (mean = −14.2 ± 19.5 % versus 2.3 ± 14.8 %), ACC (mean = −14.8 ± 23.7 % versus 2.4 ± 15.7 %). The effects on CMRO 2 in those regions were primarily driven by patients with longer disease duration and higher mood instability. Sample size; medications potentially impacting on response to MB. An altered neurometabolic response to MB, a mitochondrial/hemodynamic modulator, was observed in patients, supporting the hypothesis of vulnerability to neurometabolic stress in BD. Integrating quantitative imaging of cerebral oxygen metabolism with a mitochondrial-targeting pharmacological challenge could provide a novel biomarker of neurometabolic and cerebrovascular pathophysiology in BD. • Methylene Blue reduced cerebral blood flow and oxygen metabolism. • The response to Methylene Blue was altered in patients with Bipolar Disorder. • Disease duration and mood instability were associated with altered response. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this work is to apply multi‐echo spin‐ and gradient‐echo (SAGE) echo‐planar imaging (EPI) combined with a navigator‐based (NAV) prospective motion compensation method for a quantitative liver blood oxygen level dependent (BOLD) measurement with a breath‐hold (BH) task. Methods: A five‐echo SAGE sequence was developed to quantitatively measure T2 and T2* to depict function with sufficient signal‐to‐noise ratio, spatial resolution and sensitivity to BOLD changes induced by the BH task. To account for respiratory motion, a navigator was employed in the form of a single gradient‐echo projection readout, located at the diaphragm along the inferior–superior direction. Prior to each transverse imaging slice of the spin‐echo EPI‐based readouts, navigator acquisition and fat suppression were incorporated. Motion data was obtained from the navigator and transmitted back to the sequence, allowing real‐time adjustments to slice positioning. Six healthy volunteers and three patients with liver carcinoma were included in this study. Quantitative T2 and T2* were calculated at each time point of the BH task. Parameters of t value from first‐level analysis using a general linear model and hepatovascular reactivity (HVR) of Echo1, T2 and T2* were calculated. Results: The motion caused by respiratory activity was successfully compensated using the navigator signal. The average changes of T2 and T2* during breath‐hold were about 1% and 0.7%, respectively. With the help of NAV prospective motion compensation whole liver t values could be obtained without motion artifacts. The quantified liver T2 (34.7 ± 0.7 ms) and T2* (29 ± 1.2 ms) values agreed with values from literature. In healthy volunteers, the distribution of statistical t value and HVR was homogeneous throughout the whole liver. In patients with liver carcinoma, the distribution of t value and HVR was inhomogeneous due to metastases or therapy. Conclusions: This study demonstrates the feasibility of using a NAV prospective motion compensation technique in conjunction with five‐echo SAGE EPI for the quantitative measurement of liver BOLD with a BH task. [ABSTRACT FROM AUTHOR]

Green leaf volatiles (GLVs) are important signaling compounds that help to regulate plant defenses against pests and pathogens. Made through the hydroperoxide lyase (HPL) pathway, they are rapidly produced upon damage and can signal to other parts of the same plant or even plants nearby, where they can induce rapid defense responses directly or prime them against impending danger. In this primed state, plants can respond faster and/or stronger should pests or pathogens attack. However, while all proteins and genes involved in the biosynthesis of GLVs have been identified, little is still known about how the first two steps in the pathway, e.g., oxygenation by a lipoxygenase (LOX) and subsequent cleavage by HPL, are facilitated within the damaged tissue, resulting in the production of Z-3-hexenal (Z3al) as the first committed product of the pathway. Here, we provide evidence that several factors might be involved in the production of Z3al, including pH, Ca2+, and an environment that is highly hydrophobic. We present a model in which the extraordinary circumstances that are present at the site of Z3al production are considered, and shine new light on potential regulatory mechanisms. [ABSTRACT FROM AUTHOR]

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Cardiac arrest is a sudden cessation of heart function, leading to an abrupt loss of blood flow and oxygen to vital organs. This life-threatening emergency requires immediate medical intervention and can lead to severe neurological injury or death. Methods and biomarkers to predict neurological outcome are available but lack accuracy. Such methods would allow personalizing healthcare and help clinical decisions. Extensive research has been conducted to identify prognostic omic biomarkers of cardiac arrest. With the emergence of technologies allowing to combine different levels of omics data, and with the help of artificial intelligence and machine learning, there is a potential to use multiomic signatures as prognostic biomarkers after cardiac arrest. This review article delves into the current knowledge of cardiac arrest biomarkers across various omic fields and suggests directions for future research aiming to integrate multiple omics data layers to improve outcome prediction and cardiac arrest patient's care. [ABSTRACT FROM AUTHOR]

Being touched by others (social-touch) and touching oneself (self-touch) are common nonverbal behaviors in everyday interaction. The commonalities and differences between these two types of touching behavior are of particular interest for conditions when social-touch is substantially restricted such as during the corona pandemic. Neuropsychologically, pleasant social-touch is associated with increased activation in frontal brain regions such as frontopolar, dorsolateral prefrontal (dlPFC), and orbitofrontal cortices (OFC). However, for these regions a deactivation has also been reported. Likewise, for self-touch the findings are controversial. Therefore, the aim of this study is to shed light on the controversial findings and to elucidate the relation between self-touch and social-touch. From 2021 to 2022, in a quasi-naturalistic setting, in forty-six participants brain oxygenation and deoxygenation was examined during social-touch and self-touch in frontal cortices applying functional NearInfraRed Spectroscopy (fNIRS). Social-touch compared to self-touch led to a significantly higher brain deoxygenation in the frontopolar areas and in parts of the dlPFC and OFC. In contrast, brain oxygenation in the PFC was significantly increased during self-touch compared to social-touch. The cerebral activation and deactivation pattern in a quasi-naturalistic setting indicates that self-touch cannot achieve the hedonic effects of social-touch, but it can influence internally self-regulating processes. [ABSTRACT FROM AUTHOR]

Arterial spin labelling (ASL) is the only non‐invasive technique that allows absolute quantification of perfusion and is increasingly used in brain activation studies. Contrary to the blood oxygen level‐dependent (BOLD) effect ASL measures the cerebral blood flow (CBF) directly. However, the ASL signal has a lower signal‐to‐noise ratio (SNR), than the BOLD signal, which constrains its utilization in neurofeedback studies. If successful, ASL neurofeedback can be used to aid in the rehabilitation of health conditions with impaired blood flow, for example, stroke. We provide the first ASL‐based neurofeedback study incorporating a double‐blind, sham‐controlled design. A pseudo‐continuous ASL (pCASL) approach with background suppression and 3D GRASE readout was combined with a real‐time post‐processing pipeline. The real‐time pipeline allows to monitor the ASL signal and provides real‐time feedback on the neural activity to the subject. In total 41 healthy adults (19–56 years) divided into three groups underwent a neurofeedback‐based emotion imagery training of the left anterior insula. Two groups differing only in the explicitness level of instruction received real training and a third group received sham feedback. Only those participants receiving real feedback with explicit instruction showed significantly higher absolute CBF values in the trained region during neurofeedback than participants receiving sham feedback. However, responder analyses of percent signal change values show no differences in activation between the three groups. Persisting limitations, such as the lower SNR, confounding effects of arterial transit time and partial volume effects still impact negatively the implementation of ASL neurofeedback. [ABSTRACT FROM AUTHOR]

This study investigates volatile organic compound (VOC) profiles in the exhaled breath of normal subjects under different oxygenation conditions—normoxia (FiO2 21%), hypoxia (FiO2 11%), and hyperoxia (FiO2 35%)—using an electronic nose (e-nose). We aim to identify significant differences in VOC profiles among the three conditions utilizing principal component analysis (PCA) and canonical discriminant analysis (CDA). Our results indicate distinct VOC patterns corresponding to each oxygenation state, demonstrating the potential of e-nose technology in detecting physiological changes in breath composition (cross-validated accuracy values: FiO2 21% vs. FiO2 11% = 63%, FiO2 11% vs. FiO2 35% = 65%, FiO2 21% vs. FiO2 35% = 71%, and p < 0.05 for all). This research underscores the viability of breathomics in the non-invasive monitoring and diagnostics of various respiratory and systemic conditions. [ABSTRACT FROM AUTHOR]

This study aimed to assess the potential of home monitoring using a monitoring application for the early prediction of acute exacerbations (AEs) in patients with fibrosing interstitial lung diseases (F-ILDs) by tracking symptoms, peripheral blood oxygen saturation (SpO2), and heart rate (HR). Data on symptoms, SpO2, and HR before and after a 1-min sit-to-stand test (1STST) were collected using an online home monitoring application. Symptoms were recorded at least 3 times a week, including cough intensity and frequency (Cough Assessment Test scale (COAT) score), breathlessness grade (modified Medical Research Council (mMRC) score), and SpO2 and HR before and after 1STST. Eighty-five patients with stable F-ILDs were enrolled. We observed a significant increase in COAT and mMRC scores, alongside a significant decrease in SpO2 before and after 1STST, 2 weeks before the first recorded AE. Furthermore, a combination of variables-an increase in COAT (≥ 4) and mMRC(≥ 1) scores, a decrease in SpO2 at rest (≥ 5%), and a decrease in SpO2 after 1STST (≥ 4%)- proved the most effective in predicting AE onset in patients with F-ILDs at 2 weeks before the first recorded AE. Home telemonitoring of symptoms, SpO2 holds potential value for early AE detection in patients with F-ILDs. [ABSTRACT FROM AUTHOR]

Background: Upper limb motor impairment is a common consequence of stroke, and the effectiveness and underlying mechanisms of rehabilitation therapy for improving upper limb function remain uncertain. Functional nearinfrared spectroscopy, a reliable wearable neuroimaging technique, holds promise for investigating brain activity during functional tasks. This study aims to explore the synchronous oxygenation characteristics of the central cortex and upper-limb flexors during a grasping task and investigate the rehabilitation mechanisms of upper limb motor function in individuals with stroke. Methods: Participants with stroke who demonstrate the ability to grasp and lift cubic wood blocks of different sizes (2.5cm3, 5cm3, and 10cm3) using their affected hand will be divided into three groups: A, B, and C. Each group will consist of twenty stroke patients, resulting in a total of sixty participants with stroke. Additionally, twenty matched healthy subjects will be enrolled as a control group. Comprehensive assessments will be conducted before and after the intervention, including blood oxygen parameter monitoring of the cerebral cortex and upper limb flexors using fNIRS during the grasping task. Other assessments will include MyotonPRO, the Modified Ashworth Scale, the upper extremity section of the Fugl-Meyer Assessment, the Action Research Arm Test, and the Modified Barthel Index. The study will be undertaken between January 2024 and September 2025. Conclusions: The results of this trial will provide an in-depth understanding of the Characteristics of central cortex and upper-limb flexors synchronous oxygenation during grasping task and how it may relate to the rehabilitation mechanism of upper limb motor function in people with stroke. [ABSTRACT FROM AUTHOR]

Objectives: Hypoperfusion and tissue hypoxia have been implicated as contributory mechanisms in the neuropathology of multiple sclerosis (MS). Our objective has been to study cortical oxygenation in vivo in patients with MS and age‐matched controls. Methods: A custom, multiwavelength time‐domain near‐infrared spectroscopy system was developed for assessing tissue hypoxia from the prefrontal cortex. A cross‐sectional case–control study was undertaken assessing patients with secondary progressive MS (SPMS) and age‐matched controls. Co‐registered magnetic resonance imaging was used to verify the location from which near‐infrared spectroscopy data were obtained through Monte Carlo simulations of photon propagation. Additional clinical assessments of MS disease severity were carried out by trained neurologists. Linear mixed effect models were used to compare cortical oxygenation between cases and controls, and against measures of MS severity. Results: Thirty‐three patients with secondary progressive MS (median expanded disability status scale 6 [IQR: 5–6.5]; median age 53.0 [IQR: 49–58]) and 20 age‐matched controls were recruited. Modeling of photon propagation confirmed spectroscopy data were obtained from the prefrontal cortex. Patients with SPMS had significantly lower cortical hemoglobin oxygenation compared with controls (−6.0% [95% CI: −10.0 to −1.9], P = 0.004). There were no significant associations between cortical oxygenation and MS severity. Interpretation: Using an advanced, multiwavelength time‐domain near‐infrared spectroscopy system, we demonstrate that patients with SPMS have lower cortical oxygenation compared with controls. [ABSTRACT FROM AUTHOR]

The pathological vascular network in malignant tumors is generally irregular and chaotic. Euoxic clonogenic tumor cells (radiosensitive) are gathered around the vessels, which are unevenly distributed within the tumor volume. The results of many clinical studies [mainly on head and neck (H&N) cancers] have convincingly shown that extension of the overall irradiation time (OTT) needs a pronounced increase in the total dose (TD). It was strongly suggested that the results reflect an accelerated clonogens repopulation, which likely neutralizes about 30% of the cell kill effect of each dose fraction, and it potentially increases to even 80% towards the end of conventional irradiation. However so far, this mechanism’s activity seems to be quantitatively exaggerated, since towards the end of irradiation, residual 10¹–10² cancer cells likely become hypoxic and highly resistant to 2 Gy fractions. Thus, local hypoxia should likely be considered as a dominant process responsible for clinical failure. Accelerated repopulation of only a few cellular survivors does not seem reliable. The efficacy of various chemical radiosensitizers, bioreductive drugs, and immuno-boosts are presented and discussed. Finally, it becomes clear that conventional 2 Gy fractionated radiotherapy should no longer be considered as an effective regimen to achieve local tumor control of locally advanced cancer higher than 50%. Pronounced improvement of the RT might be expected using an initial conventional dose of 50 Gy given in 25 fractions followed by a boost of 4–5 large dose (hypo) fractions of 5–6 Gy or by local brachytherapy. [ABSTRACT FROM AUTHOR]

Purpose: This study explored the association of the elasticity modulus and shear wave velocity (SWV) of the tibialis anterior muscle, as measured by two-dimensional shear wave elastography (2D-SWE), with the intracompartmental pressure (ICP) determined using the Whitesides method in a New Zealand rabbit model of acute compartment syndrome (ACS). Additionally, it evaluated the viability of 2D-SWE as a noninvasive, quantitative tool for the early detection of ACS. Methods: An ACS model was established through direct external compression by applying pressure bandaging to the lower legs of 15 New Zealand rabbits using neonatal blood pressure cuffs. Another five animals represented a non-modeled control group. To measure the elasticity modulus and SWV of the tibialis anterior muscles, 2D-SWE was employed. Blood oxygen saturation, serum creatine kinase (CK), and myoglobin levels were monitored. Subsequently, the anterior tibial compartment was dissected, and the tibialis anterior was removed for hematoxylin and eosin staining to assess muscle injury. Results: The elasticity modulus and SWV of the tibialis anterior muscle increased with compression duration, as did serum CK and myoglobin levels. ICP was strongly positively correlated with these parameters, particularly mean velocity (r=0.942, P<0.001) and CK (r=0.942, P<0.001). Blood oxygen saturation was negatively correlated with ICP (r=-0.887, P<0.001). Histological analysis indicated progressive muscle cell swelling over time, with damage transitioning from reversible to irreversible and culminating in necrosis. Conclusion: In a rabbit ACS model, ICP was strongly positively correlated with muscle elasticity modulus/SWV. Consequently, 2D-SWE may represent a novel tool for assessing early-phase ACS. [ABSTRACT FROM AUTHOR]