Lack Of Awareness Research Articles

Mortality risk factors in children with influenza-associated encephalopathy admitted to the paediatric intensive care unit between 2009 and 2021.

The purpose of this study was to determine the risk factors for death in children with influenza-associated encephalopathy (IAE) in the paediatric intensive care unit (PICU). Forty-six paediatric patients with IAE admitted to the PICU at shenzhen Children's Hospital between December 2009 and December 2021 were evaluated. Their clinical characteristics were retrospectively analysed. A total of 46 patients were diagnosed with influenza A virus infection and encephalopathy. The cases were concentrated in children <5 years of age (27/46, 58.7%). Twenty-nine patients (63.0%) survived and 17 patients (37.0%) died, of which 70.6% (12/17) of the patients died within 1 week of hospitalisation. Thirty-two patients (69.6%) developed neurological symptoms within 1-2 days of fever onset. Common symptoms included fever (45/46, 97.8%), loss of consciousness (39/46, 84.8%), seizures (31/46, 67.4%), cough (19/46, 41.3%), and vomiting (16/46, 34.8%). Multivariate logistic regression analysis indicated that vomiting (odds ratio [OR], 11.005), loss of consciousness (AVPU score: P; OR, 15.871), lymphopenia (OR, 8.964), alanine aminotransferase (>80 IU/L; OR, 32.060) and serum sodium concentration (>145 mmol/L or <135 mmol/L; OR, 16.264) were related to mortality. The mortality in this study population was 37.0%. Children with IAE who have corresponding clinical manifestations and abnormal examination results in PICU should be warned of the high mortality rate.

A synergistic workspace for human consciousness revealed by Integrated Information Decomposition.

How is the information-processing architecture of the human brain organised, and how does its organisation support consciousness? Here, we combine network science and a rigorous information-theoretic notion of synergy to delineate a 'synergistic global workspace', comprising gateway regions that gather synergistic information from specialised modules across the human brain. This information is then integrated within the workspace and widely distributed via broadcaster regions. Through functional MRI analysis, we show that gateway regions of the synergistic workspace correspond to the human brain's default mode network, whereas broadcasters coincide with the executive control network. We find that loss of consciousness due to general anaesthesia or disorders of consciousness corresponds to diminished ability of the synergistic workspace to integrate information, which is restored upon recovery. Thus, loss of consciousness coincides with a breakdown of information integration within the synergistic workspace of the human brain. This work contributes to conceptual and empirical reconciliation between two prominent scientific theories of consciousness, the Global Neuronal Workspace and Integrated Information Theory, while also advancing our understanding of how the human brain supports consciousness through the synergistic integration of information.

The perceptions of harmfulness. Addictiveness and social acceptance of hookah smoking among adolescents in Turkey

ABSTRACT Background Hookah smoking among adolescents is a growing public health concern, potentially fueled by a lack of awareness regarding its health risks. This study aimed to determine the risk factors associated with hookah smoking and explore adolescents’ perceptions of its harmfulness, addictiveness and social acceptability. Methods Between October 2019 and April 2020, 400 adolescents aged 12 to 18 years participated in an interviewer-administered survey including socio-demographic characteristics, past medical history, lifestyle behaviors, tobacco use of adolescents and their immediate circle, knowledge on hookah’s health risks, perceptions of hookah’s addictiveness and social acceptability. Results Among adolescents 6.8% were regular hookah smokers, while 14.5% had tried hookah at least once. Adolescents who believed hookah was not addictive were more likely to perceive it as socially acceptable (p < 0.001). The perception of social acceptance increased by 1.68 times with each year of age, 2.05 times in the presence of a smoking teacher, and 10.14 times with having tried hookah once. Conclusions This study highlights that adolescents’ limited knowledge of hookah’s negative health effects and addictive nature contributes to its social acceptance. Moreover, in addition to family members and friends, teachers significantly impact adolescents’ hookah use and their perceptions of its harmfulness, social acceptability and addictiveness.

Factors influencing cyberbullying among citizens: a systematic review of articles published in refereed journals from 2010 to 2023

Purpose Cyberbullying is a visible and prominent issue in today’s society. This study aims to identify factors influencing cyberbullying, discover its consequences on society, learn strategies and practices for dealing with cyberbullying and propose a framework to control cyberbullying in an online environment. Design/methodology/approach A systematic literature review was applied to meet the study’s objectives as the research methodology. A total of 27 peer-reviewed journal papers covering the study’s variables were included to carry out the systematic review. Findings The findings of the study revealed that social media, advancement of technology, lack of awareness, negative use of technology and smartphones affected cyberbullying in society. The study also showed the psychological disasters of cyberbullying. Prominent psychological dangers of the cyberbullying included emotional, psychiatric, psychosomatic, mental aggression, delinquency, depression, psychological distress, frustration, isolation, violence, unhappiness, suicidal tendencies, inferiority complex, embarrassment, negative emotions, self-harming attitudes and the passions of revenge. It also provided key strategies to stop and control cyberbullying activities. Key strategies included digital literacy, social support, emotional management, strict cyber laws and effective training sessions. Originality/value The study has provided a framework to stop and control cyber bullying for social survival. The study has offered significant theoretical, social and practical implications.

Identifying factors influencing program selection in health sciences by underrepresented minority students—a scoping review

There is a critical need to diversify health professionals to better serve the growing minority population in North America. Unfortunately, minority groups remain underrepresented in health professions. Despite recruitment efforts by government and academic institutions, fewer underrepresented minority (URM) students choose careers in healthcare. Identifying the key factors influencing URM students’ decisions to pursue health sciences programs could enhance diversity in these programs through targeted admissions strategies, ultimately leading to a more diverse future healthcare workforce. This scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. Five electronic databases and gray literature were searched to identify North American papers published between 1942 and 2022. Identified studies focused on URM students’ perceptions of facilitators and barriers to matriculate into a health science degree. Twenty-one articles were analyzed. Following content analysis, the facilitators and barriers identified comprised personal, socio-cultural, institutional, and financial. The most frequent facilitators reported were scholarships, family support, and the presence of role models. Common barriers included high tuition fees, pre-admission criteria, lack of awareness about the health profession, availability of financial aid, and the admission process. The findings of this review will facilitate the development and implementation of customized, comprehensive strategies to recruit more URM students to health science programs in the future, thereby improving efforts toward creating a diverse healthcare workforce.

Pengawasan Kedisiplinan Peserta Didik di SMA Negeri 1 Pangkalan Lampam

This research aims to understand the process of student discipline supervision at SMA Negeri 1 Pangkalan Lampam. The researcher uses a descriptive qualitative approach with a qualitative research type. The research method employed is descriptive, with data collection techniques including observation, interviews, and documentation. The data analysis techniques used are data reduction, data presentation, and data verification. The validity of the data in this research is tested using source triangulation, technique triangulation, and time triangulation. The analysis results indicate that the process of supervising student discipline at SMA Negeri 1 Pangkalan Lampam involves monitoring, inspection, guidance and direction, disciplinary actions, and corrective measures. The research concludes that the supervision of student discipline at SMA Negeri 1 Pangkalan Lampam is not yet optimal, particularly in the stages of guidance or direction and disciplinary actions. This is evidenced by the students' lack of awareness regarding the importance of discipline in school

Substantia Innominata Glutamatergic Neurons Modulate Sevoflurane Anesthesia in Male Mice.

Accumulated evidence suggests that brain regions that promote wakefulness also facilitate emergence from general anesthesia (GA). Glutamatergic neurons in the substantia innominata (SI) regulate motivation-related aversive, depressive, and aggressive behaviors relying on heightened arousal. Here, we hypothesize that glutamatergic neurons in the SI are also involved in the regulation of the effects of sevoflurane anesthesia. With a combination of fiber photometry, chemogenetic and optogenetic tools, behavioral tests, and cortical electroencephalogram recordings, we investigated whether and how SI glutamatergic neurons and their projections to the lateral hypothalamus (LH) regulate sevoflurane anesthesia in adult male mice. Population activity of glutamatergic neurons in the SI gradually decreased upon sevoflurane-induced loss of consciousness (LOC) and slowly returned as soon as inhalation of sevoflurane discontinued before recovery of consciousness (ROC). Chemogenetic activation of SI glutamatergic neurons dampened the animals' sensitivity to sevoflurane exposure, prolonged induction time (mean ± standard deviation [SD]; 389 ± 67 seconds vs 458 ± 53 seconds; P = .047), and shortened emergence time (305 seconds, 95% confidence interval [CI], 242-369 seconds vs 207 seconds, 95% CI, 135-279 seconds; P = .004), whereas chemogenetic inhibition of these neurons facilitated sevoflurane anesthesia. Furthermore, optogenetic activation of SI glutamatergic neurons and their terminals in LH induced cortical activation and behavioral emergence from different depths of sevoflurane anesthesia. Our study shows that SI glutamatergic neuronal activity facilitates emergence from sevoflurane anesthesia and provides evidence for the involvement of the SI-LH glutamatergic pathway in the regulation of consciousness during GA.

Cadaveric organ donation: Indian perspective

Cadaveric organ donation in India, although started long back; its present status is not favourable. The percentage gain is very slow in comparison to most of the country even after having proper legislation. There are many reasons for this, lack of awareness being the most common. Most of the people does not know the concept of brain death. Although government and many NGOs are attached with it and are trying their level best to communicate with people for this noble cause, they have not yet reached the expected goal.To boost up the process of cadaveric organ donation, the hospitals and their staff including doctors must play a vital role. Hence, knowledge and orientation of such potential group is important for further processing because in most of the hospitals even doctors are not well-informed about the legal and ethical aspects of organ donation. If all the weak locus are addressed properly, we can definitely achieve the goals within a short span of time.

Common variable immunodeficiency- A delayed diagnosis of an underdiagnosed entity in resource limited setting

We report a case of common variable immunodeficiency (CVID) in a 42-year-old female who presented with history of recurrent rhinosinusitis for the last ten years. Patient had developed cough and progressive dyspnoea for last one year. Patient was admitted with community acquired pneumonia and sputum culture was positive for Pseudomonas aeruginosa. Common variable immunodeficiency was diagnosed ten years after the onset of symptoms. CVID is an underdiagnosed disorder because of the low index of suspicion, lack of awareness, poor facilities for the investigations and higher prevalence of infectious diseases in developing countries. CVID should be suspected in patients with recurrent rhinosinusitis or pneumonia and evaluation of serum immunoglobulins is advised.

Intracranial dissemination of Klebsiella pneumoniae originating from pulmonary infection: a case report

BackgroundMetastatic brain abscesses caused by Klebsiella pneumoniae are extremely rare but life-threatening conditions. To depict a unique case of the middle-aged hypertensive man with an unusual presentation of metastatic brain abscesses originating from a pleural abscess caused by Klebsiella pneumoniae and subsequently leading to loss of consciousness (LOC).Case reportA 52-year-old Iranian man with a history of hypertension presented to the emergency department with a five-day history of worsening cough, high-grade fever, shortness of breath, chest pain, fatigue, and a productive cough. Laboratory tests revealed leukocytosis, elevated C-reactive protein, and respiratory alkalosis. A chest computed tomography scan confirmed pneumonia, and a brain scan revealed multiple hypodense lesions. Despite antibiotic therapy, the patient's condition worsened, leading to confusion, disorientation, and loss of consciousness. Magnetic resonance imaging revealed multiple ring-enhancing lesions, suggesting an abscess formation. Bronchial washings and BAL samples confirmed a lower respiratory tract infection. Cultures from the bronchial washings grew Klebsiella pneumoniae.ConclusionsMetastatic brain abscesses caused by Klebsiella pneumoniae are exceedingly rare but life-threatening conditions. Timely diagnosis and effective antimicrobial treatment are critical for patient outcomes. This case underscores the significance of recognizing atypical presentations of bacterial infections, as early detection and appropriate management can significantly impact patient outcomes.

Evaluating Factors That Influence Influenza Vaccination Uptake among Pregnant People in a Medically Underserved Area in Washington State

Introduction: Despite substantial evidence demonstrating the effectiveness of influenza vaccines, only 38.6% of the adult United States population received an influenza vaccine during the 2023–2024 flu season. Vaccination rates are typically lower among U.S. minority groups, and in 2022, pregnant persons from U.S. minority racial and ethnic groups showed a decrease in influenza vaccine coverage. Methods: A survey was conducted with residents of Yakima County, Washington, which is home to one of the state’s largest percentages of people who identify as Hispanic or Latino/a. The objective was to evaluate the uptake of influenza vaccine among pregnant persons. Surveys were sent to a random sample of 3000 residential mailing addresses. Of the 500 respondents, 244 (52.1%) reported that they had been pregnant, with those identifying as Hispanic or Latino/a constituting 23.8% of this total. Only 62 (26.2%) reported being immunized against influenza during pregnancy. Respondents who were immunized against influenza chose to be vaccinated to protect themselves from the flu (85.5%, n = 53); because a healthcare provider recommended getting vaccinated (85.5%, n = 53); to protect the baby from the flu (82.3%, n = 51); because it was available for free or low cost (62.9%, n = 39); and because vaccination was convenient (54.8%, n = 34). Qualitative evaluation identified that participants who were not vaccinated against influenza during pregnancy believed the vaccination was not needed, was not recommended by a healthcare provider, was difficult to access, they were against vaccination in general, or they were concerned about the safety and ingredients of the vaccine. Conclusion: Barriers to vaccination identified in this study included vaccine distrust, lack of awareness, and concerns about vaccine efficacy and safety. Healthcare providers can help address these concerns by providing education and recommendations about the importance of influenza vaccination during pregnancy.

Elemental Diet as a Therapeutic Modality: A Comprehensive Review.

Elemental diets have been employed for the management of various diseases for over 50years, with several mechanisms mediating their beneficial effects. Yet, they are underutilized due to poor palatability, access, cost, and lack of awareness regarding their clinical efficacy. Therefore, in this review, we aimed to systematically search and review the literature to summarize the formulation variability, mechanisms of action, clinical applications, and tolerability of the elemental diets in gastrointestinal diseases. While large prospective trials are lacking, elemental diets appear to exhibit objective and subjective clinical benefit in several diseases, including eosinophilic esophagitis, eosinophilic gastroenteritis, inflammatory bowel diseases, small intestinal bacterial overgrowth,intestinal methanogen overgrowth, chemoradiotherapy-associated mucositis, and celiac disease. Although some data support the long-term use of elemental diets as an add-on supplement for chronic pancreatitis and Crohn's disease, most of the literature on exclusive elemental diets focuses on inducing remission. Therefore, subsequent treatment strategies for maintaining remission need to be adopted in chronic/relapsing diseases. Several mechanistic pathways were identified to mediate the effects of elemental diets, including food additive and allergen-free content, high passive absorption rate, and anti-inflammatory properties. High rates of intolerance up to 40% are seen in the trials where exclusive elemental diets were administered orally due to poor organoleptic acceptability; however, when tolerated, adverse events were rare. Other limitations of elemental diets are cost, access, and lifestyle/social restrictions. Moreover, judicious use is advised in presence of a concomitant restrictive food intake disorders. Elemental diets offer a potentially highly efficacious dietary intervention with minor side effects. Palatability, cost, access, and social restrictions are common barriers of use. Prospective clinical trials are needed to elucidate the role of elemental formulas in the management of individual diseases.

Sex Differences Across Concussion Characteristics in US Service Academy Cadets: A CARE Consortium Study.

To describe sex differences in concussion characteristics in US Service Academy cadets. Descriptive epidemiology study. Four US service academies. 2209 cadets (n = 867 females, n = 1342 males). Sex. Injury proportion ratios (IPR) compared the proportion of injuries by sex (females referent) for injury situation, certainty of diagnosis, prolonged recovery, recurrent injuries, mental status alterations, loss of consciousness (LOC), posttraumatic amnesia (PTA), retrograde amnesia (RGA), motor impairments, delayed symptom presentation, and immediate reporting. Concussions from varsity/intercollegiate sports [IPR of 1.73, 95% confidence interval (CI) 1.43-2.10] and intramurals (IPR of 1.53, 95% CI 1.02-2.32) accounted for a larger proportion in males, whereas concussions outside of sport and military activities accounted for a smaller proportion among males (IPR of 0.70, 95% CI 0.58-0.85). The proportion of concussions with prolonged recovery was lower among males (IPR of 0.69, 95% CI 0.60-0.78), while concussions with altered mental status (IPR of 1.23, 95% CI 1.09-1.38), LOC (IPR of 1.67, 95% CI 1.17-2.37), PTA (IPR of 1.94, 95% CI 1.43-2.62), and RGA (IPR of 2.14, 95% CI 1.38-3.31) accounted for a larger proportion among males. A larger proportion of concussions that were immediately reported was observed in males (IPR of 1.15, 95% CI 1.00-2.31). Proportions of other characteristics (e.g., recurrent injuries) were not different between sexes. A higher proportion of concussions occurred outside of sport and military training for female cadets, who also displayed proportionally longer recovery times than males, despite males demonstrating a higher proportion of LOC, PTA, and RGA. Possible factors may include different mechanisms of injury outside of sport and military training, different biopsychosocial states associated with sex or injury context, and delayed injury reporting when outside of an observed environment, possibly secondary to perceived stigma about reporting injuries.

Distinct dynamic connectivity profiles promote enhanced conscious perception of auditory stimuli

The neuroscience of consciousness aims to identify neural markers that distinguish brain dynamics in healthy individuals from those in unconscious conditions. Recent research has revealed that specific brain connectivity patterns correlate with conscious states and diminish with loss of consciousness. However, the contribution of these patterns to shaping conscious processing remains unclear. Our study investigates the functional significance of these neural dynamics by examining their impact on participants’ ability to process external information during wakefulness. Using fMRI recordings during an auditory detection task and rest, we show that ongoing dynamics are underpinned by brain patterns consistent with those identified in previous research. Detection of auditory stimuli at threshold is specifically improved when the connectivity pattern at stimulus presentation corresponds to patterns characteristic of conscious states. Conversely, the occurrence of these conscious state-associated patterns increases after detection, indicating a mutual influence between ongoing brain dynamics and conscious perception. Our findings suggest that certain brain configurations are more favorable to the conscious processing of external stimuli. Targeting these favorable patterns in patients with consciousness disorders may help identify windows of greater receptivity to the external world, guiding personalized treatments.

Challenges to the adoption of biomimicry as a sustainable approach in the nigerian construction industry

ABSTRACT Nigeria's construction industry, which mirrors a global trend, actively seeks methods to ensure a sustainable future. Sustainable construction practices have become a focal point for research and development, and biomimicry presents significant potential in achieving this goal. However, despite its advantages, challenges impede its widespread adoption. This study employed a multi-pronged approach, combining an in-depth literature review with descriptive and exploratory factor analysis (EFA) of data collected through well-structured questionnaires administered to construction professionals. The study of 243 responses, alongside existing literature, suggests that a lack of awareness regarding biomimicry principles presents the primary barrier to its adoption. Furthermore, the identified challenges were categorised into three distinct groups: regulatory, institutional, and attitudinal. To address the challenges of biomimicry adoption in the construction industry, the paper proposes a three-pronged solution: implementing regulatory measures, improving professional practices, and prioritising stakeholder education.

Physical activity and sedentary behavior perceptions in overweight and obese adults: A systematic review of qualitative study

Background One of the largest hazards to human health is obesity, which is intimately related to sedentarism and physical inactivity. Understanding the perspectives and attitudes of adults with overweight or obesity towards their lifestyle choices related to sedentary behavior and physical activity is essential for mitigating associated health risks. Objective This systematic review aims to collate the extent of qualitative research on the perception of sedentary behavior and physical activity among adults with overweight and obesity. Methods A comprehensive search of Scopus, PubMed, CINAHL, and Web of Science, databases was conducted, which yielded 2,881 articles. A total of 2591 abstracts were screened, and 45 full-text articles were examined. A total of nine qualitative studies involving adults with overweight or obesity (BMI &gt; 25 kg/m2) were included in this systematic review. Data extraction utilized Rayyan.qcri.org software, and studies were critically appraised using Joanna Briggs’s Institute checklist for qualitative research. Results The included studies revealed a diverse array of themes, wherein a few perceived factors reported towards sedentary behavior were lack of awareness about the hazards, mode of relaxation, family commitment, technology use, motivation deficits, and fatigue. Barriers to physical activity encompassed social, cultural, and environmental factors. In contrast, peer support, fitness facility access, accountability, mental health awareness, well-being, and weight management facilitate physical activity involvement. Conclusion Perceptions in overweight and obese adults on sedentary living and exercise are intricate and multifaceted. This review provides valuable insights that can inform clinicians and researchers in promoting regular physical activity for adults with overweight and obesity.

The Development and Impact of a Blood Unity Application

This research focuses on the development and impact of a Blood Unity Application. Blood shortage is still a major problem in the medical sector. Emergencies come as last minute requirements and are very crucial. Inadequate blood and compatability problems make it difficult to manage the blood supply effectively. Sometimes, a lack of awareness and communication causes those who might be eager to donate to be unaware of the efforts that are running. To avoid these challenges we have designed an app which acts as a bridge between the donors and the people in need. In this paper, we present an overview of a website and a mobile application designed for blood donation. It is a user- friendly application where we collaborate the donors and hospitals to the people in need. By creating this application, we can assure a safe and secure blood transfusion. Anyone in need of blood at any time can download this app right away and use it to locate nearby donors who have the necessary blood type. We make the donors contact information available through the app to all registered users, enabling them to get in touch with them directly in case of emergency. We have also made a website similar to the app to use through PCs or Laptops from anywhere and at anytime. The website was developed through HTML, CSS, Bootstrap at frontend and PHP, MYSQL at backend and Angular Java Script at control end. The app was developed using Apache Cordova.

Case report: First experience with stimulating anterior thalamic nuclei in pharmacoresistant epilepsy in Kazakhstan

IntroductionPharmacoresistant epilepsy is a multicomponent disease that can be successfully treated surgically if the surgical tactics are properly defined. We present the first case of stimulation of anterior thalamic nuclei in pharmacoresistant epilepsy in Kazakhstan. This will be a new opportunity for Kazakhstanis diagnosed with epilepsy to achieve stable epilepsy remission.MaterialsThe patient was born in 2000. The first episode of tonic clonic seizures with loss of consciousness occurred in 2014. Repeatedly underwent therapeutic and diagnostic measures in the neurological department. The frequency of seizures increased in dynamics. The results of instrumental examination revealed the following morphological changes: Morphological changes: Focal cortical dysplasia (FCD) in the left cingulate gyrus, hypometabolism in the left thalamus and forehead, signs of hippocampal sclerosis on both sides. Electroencephalogram (EEG) shows activity in frontal areas on both sides, more on the right. Based on clinical and instrumental data according to the 2017 ILAE classification, the diagnosis was Structural focal frontal lobe epilepsy with bilateral tonic-clonic seizures. FCD of the left cingulate gyrus. Resistance to antiepileptic therapy.MethodsThe patient was hospitalized in the department of neurosurgery. In light of the evidence indicating structural changes in the brain substance and ambiguous EEG findings, the indications for deep brain stimulation (DBS) of the anterior nucleus (ANT) were made. Electrode implantation was performed under general anesthesia, and preoperative computer tomography (CT) scans were performed using the CRW® stereotactic system in combination with magnetic resonance imaging (MRI) scans using Brainlab Neuronavigation with 3D Atlas to identify the anterior thalamic nuclei.ConclusionThe observed structural changes in the brain substance and the ambiguous EEG results call into question the efficacy of surgical procedures aimed at removing existing foci or destroying them. Based on the above, as well as the experience of foreign colleagues, the choice of neurosurgeons was DBS ANT. Although the selection of ideal candidates for thalamic stimulation is still controversial, in the described case we were able to achieve control of seizure activity. The patient was seizure free for 2 months after surgery. The patient was discharged on postoperative day 7.

Effects of ciprofol infusion on hemodynamics during induction and maintenance of anesthesia and on postoperative recovery in patients undergoing thoracoscopic lobectomy: Study protocol for a randomized, controlled trial.

Ciprofol, a new candidate drug, is effective and safe for the maintenance of anesthesia in non-cardiothoracic and non-neurological elective surgery. However, few studies have been conducted on general anesthesia using ciprofol in patients undergoing thoracoscopic lobectomy. Therefore, this study aims to observe the effects of ciprofol on hemodynamics and on postoperative recovery in patients undergoing thoracoscopic lobectomy. This randomized controlled trial will include 136 patients aged 18-65 years undergoing elective thoracoscopic lobectomy between April 2023 and December 2024. The participants will be randomly assigned to the propofol or ciprofol group. The primary outcome to be assessed is the hemodynamic fluctuation during the induction and maintenance of anesthesia. The secondary outcomes involve quality of anesthesia induction and quality of recovery from anesthesia. The former includes TLOC (time to loss of consciousness), the use of vasoactive agents, the incidence of injection pain, body movement, muscle twitching and coughing during induction of anesthesia. The latter includes TROC (time to recovery of consciousness), post anesthesia care unit (PACU) time, incidence of postoperative nausea and vomiting (PONV), postoperative agitation, intraoperative awareness and quality of recovery (QoR) score. A number of clinical trials have confirmed that ciprofol, as a new sedative-hypnotic agent, has advantages of better tolerance, higher sedation satisfaction score, and lower incidence of adverse reactions, especially in reducing the incidence of injection pain. But considering that ciprofol was recently developed, limited data are available regarding its use for general anesthesia. This study aims to investigate the effects of ciprofol on hemodynamics and on postoperative recovery of patients undergoing thoracoscopic lobectomy. The results of this study may provide evidence for the safe application of ciprofol, a new choice of general anesthetic for thoracic surgery. ClinicalTrials.gov (NCT05664386).

Association of Sport Helmet Status on Concussion Presentation and Recovery in Male Collegiate Student-Athletes.

Sporting helmets contain force attenuating materials which reduce traumatic head injury risk and may influence sport-related concussion (SRC) sequelae. The purpose of this study was to examine the association of sport helmet status with SRC-clinical presentation and recovery trajectories in men's collegiate athletes. Sport helmet status was based on the nature of sports being either helmeted/non-helmeted. 1070 SRCs in helmeted (HELM) sports (Men's-Football, Ice Hockey, and Lacrosse), and 399 SRCs in non-helmeted (NOHELM) sports (Men's-Basketball, Cheerleading, Cross Country/Track & Field, Diving, Gymnastics, Soccer, Swimming, Tennis, and Volleyball) were analyzed. Multivariable negative binomial regression models analyzed associations between sport helmet status and post-injury cognition, balance, and symptom severity, adjusting for covariate effects (SRC history, loss of consciousness, anterograde/retrograde amnesia, event type). Kaplan-Meier curves evaluated median days to: initiation of return to play (iRTP) protocol, and unrestricted RTP (URTP) by sport helmet status. Log-rank tests were used to evaluate differential iRTP/URTP between groups. Two independent multivariable Weibull accelerated failure time models were used to examine differential iRTP and URTP between groups, after adjusting for aforementioned covariates and symptom severity score. Overall, the median days to iRTP and URTP was 6.3 and 12.0, respectively, and was comparable across NOHELM- and HELM-SRCs. Post-injury symptom severity was lower (Score Ratio 0.90, 95%CI 0.82, 0.98), and cognitive test performance was higher (Score Ratio 1.03, 95%CI 1.02, 1.05) in NOHELM-compared to HELM-SRCs. Estimated time spent recovering to iRTP/URTP was comparable between sport helmet status groups. Findings suggest that the grouping of sports into helmeted and non-helmeted show slight differences in clinical presentation but not recovery.