Dissolved Oxygen Research Articles

Study on cerebral oxygen saturation in children with sleep-disordered breathing.

To explore the association between the severity of sleep-disordered breathing, different types of respiratory events, peripheral oxygen saturation (SpO2), age and sleep stage on cerebral oxygen saturation (rSO2) in children. We enrolled children aged 4-14 years who were treated for snoring or mouth breathing at the Sleep Center of Beijing Children's Hospital, from February 2022 to July 2022. All children completed polysomnography, and SpO2, rSO2, and heart rate (HR) were recorded synchronously. A total of 70 children were included, including 16 (22.9%) with primary snoring, 38 (54.3%) with mild obstructive sleep apnea (OSA), and 16 (22.9%) with moderate-to-severe OSA. There were no significant differences in the mean rSO2 or minimum rSO2 among the primary snoring, mild OSA, and moderate-to-severe OSA groups (all p > 0.05). A total of 1119 respiratory events were included in the analysis. Regardless of the type of respiratory event, rSO2 and HR changes occur prior to fluctuations in SpO2. A mixed-effects model showed that ΔrSO2 was positively correlated with ΔSpO2, duration of respiratory event, mixed and obstructive apnea, central apnea, while negatively correlated with age and rapid eye movement (REM) sleep stage (all p < 0.05). Larger rSO2 fluctuations were impacted by a greater ΔSpO2, longer duration of respiratory events, younger age, apnea-related respiratory events and non-REM sleep stage. Thus, sleep disordered breathing in younger children warrants more attention. More research is needed to determine whether REM sleep has special protective effects on rSO2.

Internet of Things-Driven Precision in Fish Farming: A Deep Dive into Automated Temperature, Oxygen, and pH Regulation

The research introduces a revolutionary Internet of Things (IoT)-based system for fish farming, designed to significantly enhance efficiency and cost-effectiveness. By integrating the NodeMcu12E ESP8266 microcontroller, this system automates the management of critical water quality parameters such as pH, temperature, and oxygen levels, essential for fostering optimal fish growth conditions and minimizing mortality rates. The core of this innovation lies in its intelligent monitoring and control mechanism, which not only supports accelerated fish development but also ensures the robustness of the farming process through automated adjustments whenever the monitored parameters deviate from desired thresholds. This smart fish farming solution features an Arduino IoT cloud-based framework, offering a user-friendly web interface that enables fish farmers to remotely monitor and manage their operations from any global location. This aspect of the system emphasizes the importance of efficient information management and the transformation of sensor data into actionable insights, thereby reducing the need for constant human oversight and significantly increasing operational reliability. The autonomous functionality of the system is a key highlight, designed to persist in adjusting the environmental conditions within the fish farm until the optimal parameters are restored. This capability greatly diminishes the risks associated with manual monitoring and adjustments, allowing even those with limited expertise in aquaculture to achieve high levels of production efficiency and sustainability. By leveraging data-driven technologies and IoT innovations, this study not only addresses the immediate needs of the fish farming industry but also contributes to solving the broader global challenge of protein production. It presents a scalable and accessible approach to modern aquaculture, empowering stakeholders to maximize output and minimize risks associated with fish farming, thereby paving the way for a more sustainable and efficient future in the global food supply.

Comparing the Effect of Granisetron with Meperidine on Post-Shivering in Elective Cesarean Section under Spinal Anesthesia

Background: Post-operative shivering after spinal anesthesia is a common issue in women undergoing cesarean section, then its management is necessary to increase patients’ satisfaction. Therefore, the current study aimed to compare the prophylactic effect of Granisetron and meperidine on post-spinal shivering in elective cesarean section. Methods: In this double-blinded clinical trial study, 100 women under elective cesarean section using block randomization were divided into two groups. The spinal anesthesia was performed in all women with 10 mg hyperbaric bupivacaine 0.5 %. Then, after the birth of the baby, the patients received 0.04 mg/kg Granisetron or 0.4 mg/kg meperidine intravenously. Mean Arterial Pressure (MAP), Heart Rate (HR), and percentage of arterial blood oxygen saturation (SpO2) were measured before intervention and 60 minutes after surgery using a standard monitoring device. Shivering was evaluated 30 minutes after the surgery in the recovery room according to the clinical examinations. Results: The changes in hemodynamics parameters were similar between the two groups. There was a statistically significant difference in the rate of shivering between the two groups. The rate of shivering in the Granisetron group was higher than in the meperidine group. Thus, 13 patients (26%) and 5 patients (10%) had shivering in the Granisetron and meperidine groups, respectively (p=0.037). Conclusion: Granisetron was not more effective than meperidine as routine treatment in preventing shivering after spinal anesthesia in women under elective cesarean section.

Dual-ratio approach to pulse oximetry and the effect of skin tone.

Pulsatile blood oxygen saturation ( ) via pulse oximetry is a valuable clinical metric for assessing oxygen delivery. Individual anatomical features, including skin tone, may affect current optical pulse oximetry methods. We developed an optical pulse oximetry method based on dual-ratio (DR) measurements to suppress individual anatomical confounds on . We designed a DR-based finger pulse oximeter, hypothesizing that DR would suppress confounds from optical coupling and superficial tissue absorption. This method is tested using Monte Carlo simulations and in vivo experiments. Different melanosome volume fractions in the epidermis, a surrogate for skin tone, cause changes in the recovered on the order of 1% in simulation and in vivo. Different heterogeneous pulsatile hemodynamics cause greater changes on the order of 10% in simulations. recovered with DR measurements showed less variability than the traditional single-distance (SD) transmission method. For the models and methods considered here, measurements are strongly impacted by heterogeneous pulsatile hemodynamics. This variability may be larger than the skin tone bias, which is a known confound in measurements. The partial suppression of variability in the recovered by DR suggests the promise of DR for pulse oximetry.

Individual heart failure patient variability in nocturnal hypoxia and arrhythmias.

Traditional heart failure research often uses daytime population parameter estimates to assess hypoxia and arrhythmias. This approach might not accurately represent heart failure patients as nighttime cardiac behaviors offer crucial insights into their health, especially regarding oxygen levels and heart rhythms. We conducted a prospective study on nocturnal oxygen saturation and heart rate in home-dwelling heart failure patients over 6 nights. Patients were recruited from the Walter Reed National Military Medical Center heart failure clinic. Criteria included a clinical diagnosis of heart failure, a New York Heart Association (NYHA) classification of I to III, ages between 21 to 90, cognitive intactness, capability to use the wearable device, and willingness to use the device for 6 consecutive nights. Average oxygen saturation was 92% with individual readings ranging from 40% to 100%. The mean heart rate was 72 beats per minute (bpm), but individual rates ranged from 18 bpm to a high of 296 bpm. A significant drop in oxygen levels and sleep arrhythmias were consistently observed among participants. Heart failure patients demonstrate notable and variable desaturations and arrhythmias across multiple nights. A single-night sleep study or a 24-hour heart rate monitor may not comprehensively depict patients' oxygenation and heart rate irregularities. Our research highlights wearable devices' potency in medical research for capturing essential nocturnal data. In only 6 nights, we gleaned invaluable clinical insights for optimizing patient care. This study is pioneering, being the first to intensively examine nighttime oxygen levels and heart rates in home-based heart failure patients.

Skeletal Muscle Oxidative Metabolism during Exercise Measured with Near Infrared Spectroscopy

This study characterized the level of oxidative metabolism in skeletal muscle during whole-body activity as a percentage of the muscle’s maximum oxidative rate (mVO2max) using near-infrared spectroscopy (NIRS). Ten healthy participants completed a progressive work test and whole-body walking and lunge exercises, while oxygen saturation was collected from the vastus lateralis muscle using near-infrared spectroscopy (NIRS). Muscle oxygen consumption (mVO2) was determined using arterial occlusions following each exercise. mVO2max was extrapolated from the mVO2 values determined from the progressive exercise test. mVO2max was 11.3 ± 3.3%/s on day one and 12.0 ± 2.9%/s on day two (p = 0.07). mVO2max had similar variation (ICC = 0.95, CV = 6.4%) to NIRS measures of oxidative metabolism. There was a progressive increase in mVO2 with walking at 3.2 Km/h, 4.8 km/h, 6.4 Km/h, and with lunges (15.8 ± 6.6%, 20.5 ± 7.2%, 26.0 ± 6.6%, and 57.4 ± 15.4% of mVO2max, respectively). Lunges showed a high reliability (ICC = 0.81, CV = 10.2%). Muscle oxidative metabolism in response to whole-body exercise can be reproducibly measured with arterial occlusions and NIRS. This method may be used to further research on mitochondrial activation within a single muscle during whole-body exercise.

Effect of needle types and diameters using in spinal anesthesia on optic nerve sheath diameter: Prospective randomized study

Background: This prospective randomized study aimed to investigate the impact of needle types and diameters used in spinal anesthesia (SA) on optic nerve sheath diameter (ONSD) in patients undergoing lower extremity orthopedic surgery. Methods: Patients were randomly assigned to 3 groups based on the needle type and size used for SA: Group 25w (25 gauge Whitacre needle), Group 27q (27 gauge Quincke needle), and Group 25q (25 gauge Quincke needle). Initially, 165 patients (55 in each group) were enrolled, with 146 patients ultimately included in the analysis (Group 25w, n = 49; Group 27q, n = 48; Group 25q, n = 49). ONSD measurements were conducted using ultrasound guidance at 5 time points: T0 (pre-SA), T1 (5 minutes post-SA), T2 (5 minutes post-tourniquet inflation), T3 (5 minutes post-tourniquet deflation), and T4 (24 hours post-operation). Additionally, oxygen saturation, systolic arterial pressure, mean arterial pressure, diastolic arterial pressure, and heart rate were recorded at these time points. Results: Analysis of ONSD measurements revealed no significant differences among the groups at time points T0,T1,T2, and T4 (P = .7293, P = .4428, P = .3676, and P = .3667, respectively). However, at T3, ONSD values were significantly higher in Group 27q compared to Group 25q (P = .0325). Across all groups, the mean ONSD values measured post-tourniquet release (T3) were higher than those at T0,T2, and T4 (P &lt; .001 for all). The incidence of nausea was similar among the groups, and no cases of headache or visual impairment were reported within the initial 24 hours post-surgery. Conclusion: In conclusion, our study suggests that while subarachnoid injection and tourniquet inflation do not impact intracranial pressure (ICP), tourniquet deflation leads to an increase in ICP during lower limb surgery under SA. Therefore, caution should be exercised when using a tourniquet in patients at risk of elevated ICP.

Silver oxide integrated ionic polymer composite for wearable sensing and water purification

Integrating metal nanoparticles (NPs) with ionic polymer blends/composites showed immense interest for their potential in wearable sensors, soft robotic arms, flexible man-machine interfaces of biomedical devices, and water purification applications. However, conventional NPs attached ionic polymer composites exhibit limitations such as low sensitivity (ΔR/R), low total dissolved solids (TDS) reduction, and low phosphate (PO4-P) removal rate. Herein, ionic polymer composites (IPCs) using flower-shaped silver oxide (Ag2O) attached Poly (vinylidene fluoride) (PVDF)/ polyvinylpyrrolidone (PVP)/ionic liquid (IL) were designed and developed for wearable sensing and water purification. The IPCs demonstrated remarkably high ΔR/R values of 50, 10, and 3.5 corresponding to the wrist movement of 50°, finger movement of 180°, and chin movements respectively. The Ag2O-based IPC recorded a significant reduction of TDS from sewage water from 3405 ppm to 1035 ppm, elevated the dissolved oxygen (DO) levels in the sewage water from 1.2 mg/l to 6.8 mg/l, and removed approximately 87.38 % phosphate from sewage water. Due to the uniform distribution of Ag2O within pores of IPC, it demonstrated enhanced performance for wearable and wastewater treatment applications.

Combined endovascular interventions for pulmonary embolism at high altitude in Tibet.

Managing pulmonary embolism (PE) at extremely high altitudes poses unique challenges due to harsh environmental conditions and limited healthcare resources. This study retrospectively analyzed Tibetan PE patients in the Tibet Autonomous Region of China to evaluate the effectiveness and safety of combined endovascular interventional therapy in high-altitude areas. The average altitude of long-term residence for Tibetan patients was 3,863.4 ± 317.4 m, with an average age of 62.0 ± 16.0 years, and the time from computed tomography pulmonary angiography (CTPA) diagnosis to interventional treatment averaged 2.8 ± 2.2 days. The operation time for these patients was 106.1 ± 22.2 min, and the intraoperative dose of alteplase used was 23.3 ± 5.0 mg. All 9 patients reported profound remission of dyspnea and chest pain after endovascular interventions. The heart rate (p < 0.05) and respiratory rate (p < 0.001) of all enrolled patients were significantly decreased, and the peripheral capillary oxygen saturation (SpO2) was significantly increased (p < 0.05) after interventions. No severe complications, such as bleeding, occurred in any patient. This study demonstrated the potential clinical benefits and feasibility of combined endovascular interventional therapy for treating acute PE in extreme high-altitude regions.

The application effect of a pulmonary rehabilitation program based on empowerment theory for patients with COPD combined with heart failure.

Chronic obstructive pulmonary disease (COPD) and heart failure are often coexisting conditions that can severely impact patients' cardiopulmonary function and quality of life. Pulmonary rehabilitation programs, particularly those based on empowerment theory, may improve clinical outcomes by enhancing self-efficacy and promoting patient engagement. A total of 70 patients with COPD and heart failure admitted to our hospital's respiratory department from January 1, 2023, to April 31, 2024, were randomly assigned to either a control group (n = 35) or an observation group (n = 35). The control group received routine care, while the observation group underwent an empowerment-based pulmonary rehabilitation program in addition to routine care for 4 weeks. Lung function (forced vital capacity, forced expiratory volume in 1 second, maximum voluntary ventilation), arterial blood gas levels (partial pressure of carbon dioxide, partial pressure of oxygen, and arterial oxygen saturation), cardiac function (left ventricular ejection fraction and serum brain natriuretic peptide), cardiopulmonary function (heart rate, respiratory rate, and 6-minute walk test), self-efficacy, and rehabilitation compliance were measured before and after the intervention. There were no significant differences between the groups before the intervention (P > 0.05). After the intervention, the observation group exhibited significant improvements in lung function, arterial blood gas levels, cardiac and cardiopulmonary function, and self-efficacy scores compared with the control group (P < 0.05). Rehabilitation compliance was also significantly higher in the observation group (P < 0.05). An empowerment-based pulmonary rehabilitation program effectively improves rehabilitation compliance, lung and heart function, and self-efficacy in COPD patients with heart failure, suggesting it has strong potential for clinical application.

Oxygen reserve index vs. peripheral oxygen saturation for the prediction of hypoxemia in morbidly obese patients: a prospective observational study

BackgroundPulse oximetry is a standart of anesthesia for perioperative monitoring. Due to the principles of Hb oxygen dissociation curve, peripheral oxygen saturation has an approximate sensitivity and specificity of 90% for the detection of hypoxemia.ObjectivesThe primary outcome of the study was to evaluate ORiⓇ as an early parameter to determine hypoxia in morbidly obese patients. The secondary outcome was to compare the effectiveness of ORiⓇ with SpO2 in non-obese patients.DesignProspective, observational study.SettingDepartment of elective operating room at tertiary hospital.Patients and methodsObservational study included written informed consent from 51 patients with 19 < BMI < 25 kg/m2 and 51 patients with BMI > 40 kg/m2 undergoing an elective surgery requiring tracheal intubation. In addition to standard monitors, an ORi sensor was placed and baseline values were recorded. The patients were preoxygenated until end tidal expiratory oxygen concentration is reached to 90%. After anesthesia induction and tracheal intubation, the breathing circuit was not connected tracheal tube until the SpO2 decreased to 95%. Shapiro-Wilk, Pearson Chi-square, t-test, and Mann Whitney U test were used for the study.Main outcome measuresTimes of tolerable apnea, ORiⓇ and SpO2 values at the end of preoxygenation, beginning of intubation, beginning of the ORi alarm, when SpO2 reached 95%, and when ORi reaches a plateau.Sample size102 patients.ResultsThe alert period: time to reach ORiⓇ from 0.24 to a value of 95% SpO2 was observed as 32 s in morbidly obese patients and 94 s in patients with a normal body mass index. The SpO2 alert period was determined as time difference between 97% and 95% SpO2. The data were recorded as 15 s and 36 s, respectively. It was observed that tolerable apnea, ORiⓇ, SpO2 and added alert times were longer in patients with normal BMI compared to morbidly obese patients.ConclusionsAs a result, ORiⓇ can provide an early warning to prevent unexpected hypoxia before saturation begins to decrease in morbidly obese patients.LimitationsInability to perform arterial blood gas sampling in the time periods when we looked at the parameters to determine the relationship between ORiⓇ and PaO2.Clinical trials. gov identifierNCT05480748 registered 2022-07-29.

Predictive Value of Diaphragm and Lung Ultrasonography for Weaning Failure in Critically Ill Patients with Acute Respiratory Failure Due to COVID-19 Pneumonia.

This study analyzed weaning characteristics and assessed the association of clinical and ultrasonographic indices-maximum inspiratory pressure (MIP), rapid shallow breathing index (RSBI), peak flow expiratory (PFE), diaphragm-thickening fraction (DTF), diaphragm thickness (DT), diaphragm excursion (DE), diaphragm-RSBI (D-RSBI), and lung ultrasound (LUS) patterns-with weaning failure. This retrospective cohort study included critically ill COVID-19 patients aged 18 and older who had been on invasive mechanical ventilation for at least 48 h and undergoing weaning. Exclusion criteria included absence of ultrasound assessments, neuromuscular diseases, and chronic cardio-respiratory dysfunction. Among 61 patients, 44.3% experienced weaning failure, 27.9% failed the spontaneous breathing trial (SBT), 16.4% were re-intubated within 48 h, and 28% required tracheostomy. Weaning failure was associated with prolonged ventilation (29 vs. 7 days, p < 0.001), extended oxygen therapy, longer ICU stays, and higher ICU mortality. These patients had higher pressure support, lower oxygenation levels, a higher RSBI, and a lower MIP. While PEF, DTF, DE, and D-RSBI showed no significant differences, both right and left diaphragm thicknesses and the inspiratory thickness of the left diaphragm were reduced in failure cases. LUS scores were significantly higher before and after SBT in the failure group. Bivariate analysis identified RSBI [OR = 1.04 (95% CI = 1.01-1.07), p = 0.010], MIP [OR = 0.92 (95% CI = 0.86-0.99), p = 0.018], and LUS [OR = 1.15 (95% CI = 0.98-1.35), p = 0.025] as predictors of weaning failure; however, these associations were not confirmed in multivariate analysis. Ultrasound provides supplementary information during weaning, but no definitive association between ultrasound indices and weaning failure was confirmed in this study.

Highfield imaging of the subgenual anterior cingulate cortex in uni- and bipolar depression.

The subgenual Anterior Cingulate Cortex (sgACC), as a part of the Anterior Cingulate Cortex and the limbic system plays a crucial role in mood regulation. Previous structural and functional brain imaging studies of the sgACC have revealed alterations of Gray Matter (GM) volumes and Blood Oxygenation Level Dependent signals (BOLD) in patients with Major Depressive Disorder (MDD) and Bipolar Disorder (BD), suggesting potential biomarker traits for affective disorders. In this study we investigated the gray matter volume of the sgACC in 3 different patient groups: 40 MDD patients, of which 20 were medicated (MDDm) and 20 were unmedicated (MDDu), and 21 medicated BD patients, and compared them with 23 healthy volunteers. We examined GM volume alteration using high-resolution 7T Magnetic Resonance Imaging (MRI) which produced quantitative maps of the spin-lattice relaxation time (T1). T1 maps provide high contrast between gray and white matter, and at 7 Tesla voxels with submillimeter resolution can be acquired in a reasonable scan time. We developed a semi-automatic segmentation protocol based on refined landmarks derived from previous volumetric studies using quantitative T1 maps as raw input data for automatic tissue segmentation of GM, WM and CSF (cerebrospinal fluid) tissue. The sgACC ROI was then superimposed on these tissue probability maps and traced manually by two independent raters (F.B., M.M.) following our semi-automatic segmentation protocol. Interrater reliability was calculated on a subset of 10 brain scans for each hemisphere, showing an Intra-Class Correlation coefficient (ICC) r = 0.96 for left sgACC and r = 0.84 for right sgACC respectively. In summary, we have developed a reproducible and reliable semi-automatic segmentation protocol to measure gray matter volume in the sgACC. Based on previous findings from meta-analyses on morphometric studies of the sgACC, we hypothesized that patients with MDD would have lower gray matter sgACC volumes compared to healthy subjects. Post-hoc analysis revealed smaller subgenual volumes for the left hemisphere in both the medicated (MDDm) and non-medicated (MDDu) group versus healthy controls (p = .001, p = .008) respectively. For the right hemisphere, the (MDDu) and BD group exhibited significantly lower subgenual volumes than healthy controls (p < .001, p = .004) respectively. To our knowledge, this is the first morphometric MRI study using T1 maps obtained in high-resolution 7 Tesla MRI to compare MDD and BD patients with healthy controls.

Predicting the impact of underwater skimming on dissolved oxygen consumption in slow sand filters for potable water treatment

In a well-functioning slow sand filter (SSF), dissolved oxygen (DO) is crucial for enabling aerobic processes and microbiota growth. Given that DO supply is predominantly via the feed water, flow pauses (e.g., during cleaning) may trigger anoxic/anaerobic conditions in the stagnant filter bed. Underwater skimming (UWS) is an advanced cleaning technique that employs a skimmer with a shrouded blade, mounted on a mobile platform, to remove the fouling layer composed of sand and particles in order to improve the efficiency of slow sand filtration. As UWS results in changes to the flow pattern of the SSF, a mathematical model was developed to predict DO utilization after a flow perturbation associated with UWS operation. The model was based on a depth resolved measurement of specific oxygen utilization derived from a full scale SSF. Pilot plant experiments monitored DO in the feed and filtrate of SSFs cleaned using underwater and conventional dry skimming techniques. The highest oxygen utilization was in the Schmutzdecke layer, with additional demand imposed by the presence of a granular activated carbon (GAC) sandwich layer. It was observed that pseudo-steady state conditions occurred following filter ripening, where DO utilization, driven by biological activity, remained relatively constant regardless of filter cleaning technique. For flow pauses between three and 24 h, the pause duration's importance decreased, while the hydraulic loading rate became the critical factor for DO recovery in the filter. Additionally, introducing a ‘sweetening flow’ during UWS ensured a continuous DO supply, facilitating quicker DO replenishment post-cleaning. The model reliably predicted filtrate DO within ±0.6 mg/L, demonstrating its operational utility, especially in the optimisation of UWS methodology. As such, UWS can be applied to clean SSFs with the methodology modified to prevent any detrimental effects to DO management within the filter. This study predicted DO dynamics in SSFs, advancing UWS techniques and could be applied for enhancing water treatment strategies by filtration.

Assessing the impact of different types of masks on COPD patients: A randomized controlled trial

BackgroundWearing masks imposes an additional respiratory burden on COPD patients. This study aimed to investigate the impact of various mask types on physiological parameters and subjective feelings in COPD patients.MethodsThis randomized, open-label, parallel-controlled trial randomly assigned 129 COPD patients from 2 Chinese hospitals to the N95 mask group, the surgical mask group and the no mask group, who were required to complete a 6-minute rest (6MR) and a 6-minute walking test (6MWT) while wearing their designated masks, and were assessed for blood pressure, oxygen saturation, pulse rate, Borg score, RPE score, 6-minute walk distance (6MWD), and subjective feeling score. Data were analyzed using intention-to-treat analysis and per-protocol analysis.ResultsNo significant differences were observed in blood pressures, oxygen saturation, pulse rate, or the 6MWD among the three groups following a 6MR or 6MWT. Wearing N95 masks and surgical masks during the 6MWT significantly elevated perceived dyspnea (p&lt;0.001) and exertion scores (p&lt;0.001) in COPD patients. The differences in the 2 scores between the highest and lowest groups were 2 and 4 points, respectively.ConclusionWearing surgical masks or N95 masks for 6MR or 6MWT did not adversely affect physiological parameters in COPD patients. However, it significantly increased perceived dyspnea and exertion.

Optimizing landscape-scale coastal monitoring and reporting through predicted versus observed animal abundance models

Abstract Effective environmental management hinges on monitoring drivers of change and effectively communicating results to stakeholders. While animals are valuable for engagement, few monitoring programs successfully integrate metrics quantifying their assemblages. We studied fish responses to environmental factors (including landscape context and water quality) in a 3-year survey across six ecosystems and 13 estuaries in eastern Australia (for &amp;gt;1800 fish surveys), and developed a novel predicted versus observed approach to monitoring, grading, and reporting on animal populations. Fish species richness and the abundance of five indicator species were explained significantly by at least one spatial attribute of sites (e.g. connectivity with mangroves and the ocean), and at least one water quality metric reflecting annual median water conditions (especially turbidity, dissolved oxygen (DO), and chlorophyll a concentration). For our grading approaches, predicted values were calculated for each replicate using best-fit models for each indicator, thereby accounting for natural spatiotemporal variation and standardizing site-to-site comparisons. Evaluating six methods for translating values into graded scores for each estuary, we recommend a simple metric: the percentage of sites with observed values above predictions. We discuss this approach as useful and complementary to programs with predominantly physical parameter monitoring, and discuss challenges in establishing ongoing protocols.

Effects of dexamethasone on the EC50 of remifentanil combined with dexmedetomidine achieving analgesia during pancreatic extracorporeal shockwave lithotripsy: a prospective, randomized and controlled study

BackgroundIn addition to their classic genomic effects, glucocorticoids also manifest rapid non genomic effects. We speculate that dexamethasone has the potential prompt onset of analgesic effects. The objective of this study is to investigate the influence of a single preoperative dose of dexamethasone on the half maximal effective concentration (EC50) of remifentanil when combined with dexmedetomidine for pain relief during pancreatic extracorporeal shockwave lithotripsy (P-ESWL).MethodsA total of 60 patients undergoing P-ESWL were enrolled and randomized at 1:1 ratio into the dexamethasone (DXM) group and the placebo group. Before anesthesia induction, patients in DXM group received an intravenous injection of 8 mg dexamethasone, while subjects in placebo group received an equal dose of physiological saline. Monitored anesthesia care (MAC) was performed based on remifentanil in combination with dexmedetomidine. Remifentanil was administered by TCI with an initial target concentration of 2.5 µg/mL for both groups. A positive response was defined as that VAS score > 3 by the patient at any time during the procedure. Subsequent target concentrations were adjusted by Dixon up-down sequential method, where dose modifications were performed by 0.3 ng/mL intervals, based on the response of the previous patient. The EC50 of remifentanil for pain relief during P-ESWL treatment was calculated using Dixon’s up-and-down method. Hemodynamic variables, oxygen saturation and adverse events were also recorded.ResultsDixon up-and-down method revealed that the EC50 of remifentanil was significantly higher in placebo group (2.65 ± 0.28 ng/mL) than in DXM group (2.02 ± 0.23 ng/ml) (P < 0.001). Hemodynamic parameter exhibited a significant decrease in mean arterial pressure (MAP) and heart rate (HR) before and after induction in placebo group; however, data of the two groups were comparable (P>0.05). Less adverse events occurred in DXM group, including the incidence of postoperative nausea and vomiting (PONV) and analgesia requirement with in the first 24 h following the procedure at ward.ConclusionDexamethasone exerted analgesic effects with a rapid onset, and patients received dexamethasone 8 mg preoperative had a lower required EC50 of remifentanil during P-ESWL. It is also associated with reduced PONV in addition to reduced postoperative analgesic consumption in the first postoperative 24 h.Trial registrationRegistered in the Chinese Clinical Trial Registry (ChiCTR2300078171) on 30/11/2023.

Utilizing IoMT-Based Smart Gloves for Continuous Vital Sign Monitoring to Safeguard Athlete Health and Optimize Training Protocols.

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.

Clinical evaluation of a smart wristband for monitoring oxygen saturation, pulse rate, and respiratory rate.

Recently, photoplethysmography-based vital parameter measurements have increased in popularity. However, clinical evaluation of these measurements is lacking. The objective of this study was to rigorously evaluate the clinical accuracy and reliability of a novel photoplethysmography-based wristband for measuring key vital parameters-oxygen saturation (SpO2), respiratory rate (RR), and pulse rate (PR)-during heart catheterisations. Vital parameters obtained during heart catheterisations by means of a photoplethysmography-based wristband (CardioWatch 287-2, Corsano Health) were compared to reference measurements performed by a Nellcor fingerclip (SpO2, PR) as well as a 5-lead ECG (RR) (QMAPP Haemodynamic Monitoring module, Fysicon B.V.) by means of correlation coefficients and root means squared error (RMSE). Effects of skin colour and arm hair density were additionally evaluated. In total, 945 samples from a total of 100 patients were included in the analysis. The correlation coefficients and RSME obtained for the difference between reference and photoplethysmography-based wristband measurements were r = 0.815 and 1.6% for SpO2, r = 0.976 and 0.9 brpm for RR, and r = 0.995 and 1.3bpm for PR. Similar results were obtained across all skin colour and arm hair density subcategories. This study shows that photoplethysmography-based SpO2, RR, and PR measurements can be accurate during heart catheterisations. Future investigations are required to evaluate the wristband's performance under dynamic circumstances as well as over an extended time period. Trial registration: www.clinicaltrials.gov, NCT05566886.

The value of amide proton transfer imaging in assessing brain damage in patients with obstructive sleep apnea

ObjectiveTo investigate the application value of amide proton transfer (APT) magnetic resonance imaging in evaluating brain damage in patients with obstructive sleep apnea (OSA). Materials and methods49 OSA patients and 25 healthy individuals matched for age and sex were included as case and control groups. All study participants underwent conventional 3D T1WI and APT imaging of the head. The APT values were measured in each of the brain regions of interest (ROI). To compare the differences in APT values of each brain region between the case and control groups, to compare the differences in the efficacy of APT values of each brain region in diagnosing OSA, and to investigate the correlation between APT values of each brain region and Apnea Hypopnea Index (AHI) and minimum blood oxygen saturation. ResultsCompared to the control group, patients with OSA had elevated APT values in several brain regions (P < 0.05), and the diagnostic efficacy of the combined diagnosis of OSA by multiple brain regions is better than that by each brain region alone.Left frontal APT values were positively correlated with AHI in the case group (r = 0.33, P = 0.020).In the case group, the APT values of bilateral frontal lobe, parietal lobe, occipital lobe, left temporal lobe, right thalamus, left internal capsule, left lenticular nucleus, right cerebellar hemisphere and splenium of corpus callosum were negatively correlated with the minimum blood oxygen saturation, and the APT values for each of the above ROIs were positively correlated. ConclusionAPT imaging has a certain value in evaluating brain damage in OSA patients, which may provide a new objective imaging basis for the clinical diagnosis of OSA.