Low Oxygen Levels Research Articles

P078 Physiological hypoxia improves growth and functional differentiation of human intestinal epithelial organoids

Abstract Background The epithelium in the colonic mucosa is implicated in the pathophysiology of various diseases, including inflammatory bowel diseases and colorectal cancer. Intestinal epithelial organoids from the colon (colonoids) can be used for disease modelling and personalized drug screening. Colonoids are usually cultured at 18-21% oxygen without accounting for the physiological hypoxia in the colonic epithelium (3% to <1% oxygen). We hypothesize that recapitulating the in vivophysiological oxygen environment (i.e., physioxia) will enhance the translational value of colonoids as pre-clinical models. Here we evaluate whether human colonoids can be established and cultured in physioxia for the entire in vitro culture period and compare growth, differentiation, and immunological responses at 2% and 20% oxygen. Methods Growth from single cells to differentiated colonoids was monitored by brightfield images and evaluated with a linear mixed model. Cell composition was identified by immunofluorescence staining of cell markers and single-cell RNA-sequencing (scRNA-seq). Enrichment analysis was used to identify transcriptomic differences within cell populations. Pro-inflammatory stimuli induced chemokines and Neutrophil gelatinase-associated lipocalin (NGAL) release were analysed by Multiplex profiling and ELISA. Direct response to a lower oxygen level was analysed by enrichment analysis of bulk RNA sequencing data. Results Colonoids established in a 2% oxygen environment acquired a significantly larger cell mass compared to a 20% oxygen environment. No differences in expression of cell markers for cells with proliferation potential (KI67 positive), goblet cells (MUC2 positive), absorptive cells (MUC2 negative, CK20 positive) and enteroendocrine cells (CGA positive) were found between colonoids cultured in 2% and 20% oxygen. However, the scRNA-seq analysis identified differences in the transcriptome within stem-, progenitor- and differentiated cell clusters. Both colonoids grown at 2% and 20% oxygen secreted CX3CL1, CXCL2, CXCL5, CXCL6, CXCL10, CXCL12, CCL20, CCL25, and NGAL upon TNF + poly(I:C) treatment, but there appeared to be a lower pro-inflammatory response in 2% oxygen. Reducing the oxygen environment from 20% to 2% in differentiated colonoids altered the expression of genes related to differentiation, metabolism, mucus lining, and immune networks. Conclusion Our results suggest that colonoids studies can and should be performed in physioxia when the resemblance to in vivo conditions is important.

Physiological hypoxia improves growth and functional differentiation of human intestinal epithelial organoids.

The epithelium in the colonic mucosa is implicated in the pathophysiology of various diseases, including inflammatory bowel diseases and colorectal cancer. Intestinal epithelial organoids from the colon (colonoids) can be used for disease modeling and personalized drug screening. Colonoids are usually cultured at 18-21% oxygen without accounting for the physiological hypoxia in the colonic epithelium (3% to <1% oxygen). We hypothesize that recapitulating the in vivo physiological oxygen environment (i.e., physioxia) will enhance the translational value of colonoids as pre-clinical models. Here we evaluate whether human colonoids can be established and cultured in physioxia and compare growth, differentiation, and immunological responses at 2% and 20% oxygen. Growth from single cells to differentiated colonoids was monitored by brightfield images and evaluated with a linear mixed model. Cell composition was identified by immunofluorescence staining of cell markers and single-cell RNA-sequencing (scRNA-seq). Enrichment analysis was used to identify transcriptomic differences within cell populations. Pro-inflammatory stimuli induced chemokines and Neutrophil gelatinase-associated lipocalin (NGAL) release were analyzed by Multiplex profiling and ELISA. Direct response to a lower oxygen level was analyzed by enrichment analysis of bulk RNA sequencing data. Colonoids established in a 2% oxygen environment acquired a significantly larger cell mass compared to a 20% oxygen environment. No differences in expression of cell markers for cells with proliferation potential (KI67 positive), goblet cells (MUC2 positive), absorptive cells (MUC2 negative, CK20 positive) and enteroendocrine cells (CGA positive) were found between colonoids cultured in 2% and 20% oxygen. However, the scRNA-seq analysis identified differences in the transcriptome within stem-, progenitor- and differentiated cell clusters. Both colonoids grown at 2% and 20% oxygen secreted CXCL2, CXCL5, CXCL10, CXCL12, CX3CL1 and CCL25, and NGAL upon TNF + poly(I:C) treatment, but there appeared to be a tendency towards lower pro-inflammatory response in 2% oxygen. Reducing the oxygen environment from 20% to 2% in differentiated colonoids altered the expression of genes related to differentiation, metabolism, mucus lining, and immune networks. Our results suggest that colonoids studies can and should be performed in physioxia when the resemblance to in vivo conditions is important.

Intraoperative oxygen tension and redox homeostasis in Pseudomyxoma peritonei: A short case series.

Pseudomyxoma peritonei (PMP) is a rare malignant disease characterized by a massive multifocal accumulation of mucin within the peritoneal cavity. The current treatment option is based on complete cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy. However, the recurrence is frequent with subsequent progression and death. To date, most of the studies published in PMP are related to histological and genomic analyses. Thus, the need for further studies unveiling the underlying PMP molecular mechanisms is urgent. In this regard, hypoxia and oxidative stress have been extensively related to tumoral pathologies, although their contribution to PMP has not been elucidated. In this manuscript, we have evaluated, for the first time, the intratumoral real-time oxygen microtension (pO2mt) in the tumor (soft and hard mucin) and surrounding healthy tissue from five PMP patients during surgery. In addition, we measured hypoxia (Hypoxia Inducible Factor-1a; HIF-1α) and oxidative stress (catalase; CAT) markers in soft and hard mucin from the same five PMP patient samples and in five control samples. The results showed low intratumoral oxygen levels, which were associated with increased HIF-1α protein levels, suggesting the presence of a hypoxic environment in these tumors. We also found a significant reduction in CAT activity levels in soft and hard mucin compared with healthy tissue samples. In conclusion, our study provides the first evidence of low intratumoral oxygen levels in PMP patients associated with hypoxia and oxidative stress markers. However, further investigation is required to understand the potential role of oxidative stress in PMP in order to find new therapeutic strategies.

Hospitalized Coronavirus Disease 2019 (Covid-19) with Pre-existing Diabetes Mellitus: Comparison between Survived and Deceased Patients

Patients with pre-existing diabetes mellitus (DM) are at high risk of severe outcomes from coronavirus disease 2019 (COVID-19). However, there is limited data on these patients from South Asia, especially Bangladesh. Besides, comparative studies between survived and deceased patients with DM and COVID-19 are rare in literature. This retrospective cross-sectional study was conducted among RT-PCR confirmed COVID-19 patients with pre-existing DM in a specialized COVID-19 hospital in Bangladesh. Data from hospital records were analyzed. Among 921 RT-PCR confirmed patients with COVID-19 admitted during the study period, 231 (~25%) patients had pre-existing DM. The overall mortality and intensive care unit (ICU) mortality rate among patients with DM was 11.3% (26/231) and 46.2% (12/26), respectively. The median age of the deceased patients was slightly higher (63.5 vs. 59 years, p 0.21). The most common comorbidity in both groups was hypertension. The clinical features were not significantly different between survived and deceased. However, deceased patients had significantly lower blood oxygen level (85% vs. 93%, p &lt;0.001), and higher neutrophil-lymphocyte ratio (7.9 vs. 4.5, p 0.003) and serum ferritin levels (946.0 vs. 425.0 ng/mL, p 0.03). Glycemic status was poor in both groups. This study would help identify a subgroup of diabetic patients with COVID-19 who are at higher risk of in-hospital death requiring rigorous clinical management. Bangladesh J Microbiol, Volume 39, Number 1, June 2022, pp 1-6

Two Color Imaging of Different Hypoxia Levels in Cancer Cells.

Hypoxia (low oxygen levels) occurs in a range of biological contexts, including plants, bacterial biofilms, and solid tumors; it elicits responses from these biological systems that impact their survival. For example, conditions of low oxygen make treating tumors more difficult and have a negative impact on patient prognosis. Therefore, chemical probes that enable the study of biological hypoxia are valuable tools to increase the understanding of disease-related conditions that involve low oxygen levels, ultimately leading to improved diagnosis and treatment. While small-molecule hypoxia-sensing probes exist, the majority of these image only very severe hypoxia (<1% O2) and therefore do not give a full picture of heterogeneous biological hypoxia. Commonly used antibody-based imaging tools for hypoxia are less convenient than small molecules, as secondary detection steps involving immunostaining are required. Here, we report the synthesis, electrochemical properties, photophysical analysis, and biological validation of a range of indolequinone-based bioreductive fluorescent probes. We show that these compounds image different levels of hypoxia in 2D and 3D cell cultures. The resorufin-based probe 2 was activated in conditions of 4% O2 and lower, while the Me-Tokyo Green-based probe 4 was only activated in severe hypoxia─0.5% O2 and less. Simultaneous application of these compounds in spheroids revealed that compound 2 images similar levels of hypoxia to pimonidazole, while compound 4 images more extreme hypoxia in a manner analogous to EF5. Compounds 2 and 4 are therefore useful tools to study hypoxia in a cellular setting and represent convenient alternatives to antibody-based imaging approaches.

Pseudomonas aeruginosa is oxygen-deprived during infection in cystic fibrosis lungs, reducing the effectiveness of antibiotics.

Pseudomonas aeruginosa infects the lungs of patients with cystic fibrosis. Sputum expectorated from the lungs of patients contains low levels of oxygen, indicating that P. aeruginosa may be oxygen-deprived during infection. During in vitro growth under oxygen-limiting conditions, a P. aeruginosa reference strain increases expression of a cytochrome oxidase with a high affinity for oxygen, and of nitrate and nitrite reductases that enable it to use nitrate instead of oxygen during respiration. Here, we quantified transcription of the genes encoding these three enzymes in sputum samples from 18 infected patients, and in bacteria isolated from the sputum samples and grown in aerobic and anaerobic culture. In culture, expression of all three genes was increased by averages of 20- to 500-fold in anaerobically grown bacteria compared with those grown aerobically, although expression levels varied greatly between isolates. Expression of the same genes in sputum was similar to that of the corresponding bacteria in anaerobic culture. The isolated bacteria were less susceptible to tobramycin and ciprofloxacin, two widely used anti-pseudomonal antibiotics, when grown anaerobically than when grown aerobically. Our findings show that P. aeruginosa experiences oxygen starvation during infection in cystic fibrosis, reducing the effectiveness of antibiotic treatment.

Geography and elevation as drivers of cloacal microbiome assemblages of a passerine bird distributed across Sulawesi, Indonesia

BackgroundEmpirical field studies allow us to view how ecological and environmental processes shape the biodiversity of our planet, but collecting samples in situ creates inherent challenges. The majority of empirical vertebrate gut microbiome research compares multiple host species against abiotic and biotic factors, increasing the potential for confounding environmental variables. To minimize these confounding factors, we focus on a single species of passerine bird found throughout the geologically complex island of Sulawesi, Indonesia. We assessed the effects of two environmental factors, geographic Areas of Endemism (AOEs) and elevation, as well as host sex on the gut microbiota assemblages of the Sulawesi Babbler, Pellorneum celebense, from three different mountains across the island. Using cloacal swabs, high-throughput-amplicon sequencing, and multiple statistical models, we identified the core microbiome and determined the signal of these three factors on microbial composition.ResultsThe five most prevalent bacterial phyla within the gut microbiome of P. celebense were Proteobacteria (32.6%), Actinobacteria (25.2%), Firmicutes (22.1%), Bacteroidetes (8.7%), and Plantomycetes (2.6%). These results are similar to those identified in prior studies of passeriform microbiomes. Overall, microbiota diversity decreased as elevation increased, irrespective of sex or AOE. A single ASV of Clostridium was enriched in higher elevation samples, while lower elevation samples were enriched with the genera Perlucidibaca (Family Moraxellaceae), Lachnoclostridium (Family Lachnospiraceae), and an unidentified species in the Family Pseudonocardiaceae.ConclusionsWhile the core microbiota families recovered here are consistent with other passerine studies, the decreases in diversity as elevation increases has only been seen in non-avian hosts. Additionally, the increased abundance of Clostridium at high elevations suggests a potential microbial response to lower oxygen levels. This study emphasizes the importance of incorporating multiple statistical models and abiotic factors such as elevation in empirical microbiome research, and is the first to describe an avian gut microbiome from the island of Sulawesi.

Simulation of exchange routes on the Qinghai-Tibetan Plateau shows succession from the neolithic to the bronze age and strong control of the physical environment and production mode

The Qinghai-Tibetan Plateau (QTP) is essential for converging eastern, western, and northern prehistoric cultural spheres of Asia and Europe and for human adaptation to extreme environments. Reconstruction of the location and development of prehistoric exchange routes on the Qinghai-Tibetan Plateau underpins understanding human response to harsh environments and interaction and exchange between the three cultural spheres. This study simulates exchange routes for the Neolithic and Bronze Ages, using elevation, slope, vegetation, and rivers as cost data and site points as node data. A weighted network consisting of nodes and lines is constructed within the Qinghai-Tibetan Plateau using a weighted cumulative cyclic connectivity model among nodes-the simulation abstracts exchange routes as a path search problem on this weighted network. The final simulated route is the road with the lowest incremental cost. The results give a total length of Neolithic routes of about 16,900 km, with 15 main roads, and a total length of Bronze Age routes of approximately 16,300 km, with 18 main roads. Pathway development from the Neolithic to the Bronze Age shows an apparent successional relationship, with a spatial evolution from the marginal corridor to the marginal hinterland. The simulated routes overlap highly with archaeological evidence for transmission routes of corn and millet agriculture and wheat agriculture-domesticated animals-bronze metallurgy technology, indicating the reliability of the simulation results. Further analysis showed that the unique physical geography of the QTP constrained the formation and evolution of routes. River valleys were commonly chosen as routes to acclimatize people to the high, cold, and low oxygen levels of the Qinghai-Tibetan Plateau. Scattered small agricultural bases, established in areas of the QTP suitable for agricultural planting, are the basis for intersecting exchange routes. Road formation also reflects the clear differentiation in the agro-pastoral industry between high and low altitudes related to climate, ecological environment, and elevation. Interaction between agricultural and nomadic populations is the crucial motivation for forming and developing the exchange routes.

Assessing pH-dependent activities of virulence factors secreted by Candida albicans.

Candida albicans is an opportunistic pathogen that can thrive under adverse conditions including suboptimal pH, nutrient scarcity, and low levels of oxygen. Its pathogenicity is associated with the production of virulence factors such as extracellular hydrolytic enzymes and toxins. This study was aimed at determining the effect of external pH, substrate nature, and strain origin on protease, lipase, and hemolysin production. To achieve this objective, agar plate assays were performed at pH 5.0, 6.5, and 7.5 with substrates suitable for the detection of each family of enzymes. Moreover, the study was conducted with 20 clinical C. albicans isolates from blood, oral cavity, skin, urine, and vagina. The hydrolytic zones formed around the colonies were further measured to calculate the Ez (enzymatic zone) indexes. We found that detection of proteases in skim milk agar plates was possible for most isolates only at pH 5 (80%) and pH 6.5 (75%), whereas BSA plates could confer protease detection exclusively at pH 5 (80%). Similarly, the percentage of isolates possessing lipolytic activities was higher at pH 5 (90%) than at pH 6.5 (70%) and pH 7.5 (35%). In contrast, hemolytic activities were detected in all isolates at pH 6.5 and 7.5 but not at pH 5. Further analysis revealed that some differences in the detected activities could potentially be attributed to the anatomical origin of these isolates. Collectively, these findings suggest that the pH of the site of infection might be critical for mimicking the microenvironment employed to experimentally discover the key virulence factors.

CO2 bee anaesthetic can cause complications

Most people don't really pay attention to the air they breathe. However, if you go up a mountain, where the oxygen levels are lower, you'll notice as you huff and puff while taking a normal walk around town. Changes in the amounts of the different gases that make up the air we breathe can have noticeable effects in other animals as well, especially insects. ‘Low concentrations of carbon dioxide (CO2) are often used as an attractant or repellent’, says Anna Cressman of Pennsylvania State University, USA; however, high concentrations can cause behavioural and physiological changes, and can even result in unconsciousness. Frequently, researchers use 100% CO2 to anaesthetize insects (called CO2 narcosis), but the side-effects of exposure to high levels of CO2 are often not considered. Working with Etya Amsalem, also of Pennsylvania State University, Cressman asked what is causing these side-effects in bumblebees (Bombus impatiens) – the lack of oxygen, or the high level of CO2 itself.Carbon dioxide is usually found at levels of around 0.04% in normal air, so the duo pumped either 100% CO2, 50% CO2, normal air with low oxygen, or 100% nitrogen gas (which means that there is no oxygen) into a chamber containing bees for 1 min, recording how many of the bees passed out, and then filmed the insects to monitor how they behaved once they awoke, as well as checking how the different gases affected bees with different roles, queens and workers, in the colony.Sure enough, when the team compared the effects of pure CO2 and 100% nitrogen, the bees’ responses were quite different. Even though both gases knocked the bees out, after recovering from the sedation, the bees that had inhaled 100% CO2 had different side-effects from the bees anaesthetised with pure nitrogen. The CO2-anaesthetised bees pumped their abdomens more and the queens took longer to regain consciousness. In addition, when Cressman compared the effects of the different gases on worker and queen bees, the workers produced smaller eggs after several doses of 100% CO2, whereas the queens produced larger eggs after a single dose of the pure gas. Cressman also compared the impact of the two gases on the expression of six specific genes – involved in egg production and protection from low oxygen levels – and she discovered that the genes reacted differently.The responses of the queen bees and workers to pure CO2 also differed: the queens seemed to be more vulnerable to the gas than the workers, only requiring one dose, to begin showing side-effects during their recovery, in contrast to the workers, which required multiple doses of the gas before the side-effects became apparent. ‘The fact that the physiological changes are different suggests that CO2 is not simply depriving the bees of oxygen but does something else and is likely to have a more direct impact on cells’, Amsalem concludes.So, inhaling CO2 can affect bees with different roles in the colony in different ways, and researchers should be aware of the potential complications that this may cause when using the gas to anaesthetize insects in their experiments.

The Role of Hypoxia in Brain Tumor Immune Responses.

Oxygen is a vital component of living cells. Low levels of oxygen in body tissues, known as hypoxia, can affect multiple cellular functions across a variety of cell types and are a hallmark of brain tumors. In the tumor microenvironment, abnormal vasculature and enhanced oxygen consumption by tumor cells induce broad hypoxia that affects not only tumor cell characteristics but also the antitumor immune system. Although some immune reactions require hypoxia, hypoxia generally negatively affects immunity. Hypoxia induces tumor cell invasion, cellular adaptations to hypoxia, and tumor cell radioresistance. In addition, hypoxia limits the efficacy of immunotherapy and hinders antitumor responses. Therefore, understanding the role of hypoxia in the brain tumor, which usually does not respond to immunotherapy alone is important for the development of effective anti-tumor therapies. In this review, we discuss recent evidence supporting the role of hypoxia in the context of brain tumors.

Comparison of Epilepsy Induced by Ischemic Hypoxic Brain Injury and Hypoglycemic Brain Injury using Multilevel Fusion of Data Features

The study aims to investigate the similarities and differences in the brain damage caused by Hypoxia-Ischemia (HI), Hypoglycemia, and Epilepsy. Hypoglycemia poses a significant challenge in improving glycemic regulation for insulin-treated patients, while HI brain disease in neonates is associated with low oxygen levels. The study examines the possibility of using a combination of medical data and Electroencephalography (EEG) measurements to predict outcomes over a two-year period. The study employs a multilevel fusion of data features to enhance the accuracy of the predictions. Therefore this paper suggests a hybridized classification model for Hypoxia-Ischemia and Hypoglycemia, Epilepsy brain injury (HCM-BI). A Support Vector Machine is applied with clinical details to define the Hypoxia-Ischemia outcomes of each infant. The newborn babies are assessed every two years again to know the neural development results. A selection of four attributes is derived from the Electroencephalography records, and SVM does not get conclusions regarding the classification of diseases. The final feature extraction of the EEG signal is optimized by the Bayesian Neural Network (BNN) to get the clear health condition of Hypoglycemia and Epilepsy patients. Through monitoring and assessing physical effects resulting from Electroencephalography, The Bayesian Neural Network (BNN) is used to extract the test samples with the most log data and to report hypoglycemia and epilepsy patients non-invasively. The experimental findings demonstrate that the suggested strategy improves accuracy by 95.05% and reduces the error rate to 0.41 when comparing diseases.

Efficient degassing and ppm-level oxygen monitoring flow chemistry system.

Low oxygen levels are critical for a long range of chemical transformations carried out in both flow and batch chemistry. Here, we present an inline continuous flow degassing system based on a gas-permeable membrane inside a vacuum chamber for achieving and monitoring ppm-level oxygen concentrations in solutions. The oxygen presence was monitored with a molecular oxygen probe and a continuously running UV-vis spectrometer. An automated setup for discovering optimal reaction conditions for minimal oxygen presence was devised. The parameters tested were: flow rate, vacuum pressure, solvent back-pressure, tube material, tube length and solvent oxygen solubility. The inline degassing system was proven to be effective in removing up to 99.9% of ambient oxygen from solvents at a flow rate of 300 μl min-1 and 4 mbar vacuum pressure inside the degassing chamber. Reaching lower oxygen concentrations was limited by gas permeation in the tubing following the degassing unit, which could be addressed by purging large volume flow reactors with an inert gas after degassing or by using tubing with lower gas permeability, such as stainless steel tubing. Among all factors, oxygen solubility in solvents was found to play a significant role in achieving efficient degassing of solvents. The data presented here can be used to choose optimal experimental parameters for oxygen-sensitive reactions in flow chemistry reaction setups. The data were also fitted to an analytically derived model from simple differential equations in physical context of the experiment.

Fish remains from the Rhaetian (Late Triassic) of Winterswijk, the Netherlands (Pisces: Chondrichthyes and Actinopterygii)

Abstract Chondrichthyan and actinopterygian fish remains from Rhaetian (c. 208.05–201.36 Ma) or perhaps Late Norian deposits in the Winterswijk quarry are described. The most abundant taxon is the actinopterygian Gyrolepis albertii, followed by the chondrichthyan Lissodus minimus. Furthermore, the palaeopterygian actinopterygians Saurichthys longidens and Birgeria acuminata, and some teeth of neopterygians Sargodon tomicus, ‘Lepidotes’ sp. and indeterminate pycnodontiforms are recorded in addition to the chondrichthyans Rhomphaiodon minor, Parascylloides turnerae and some ‘Hybodus’ cf. cuspidatus (senior synonym of H. cloacinus). Chondrichthyan dermal denticles, actinopterygian scales and gill rakers, tooth plates, and some fish bones were also found. There is considerable faunal resemblance to the various localities from the Rhaetian of the British Penarth Group, although it depends on the location as to whether chondrichthyans or actinopterygians prevail in the samples. On average, there are more chondrichthyan teeth present in the British samples than actinopterygian teeth, which is opposite to the situation in Winterswijk. That might be explained by different ecological circumstances, such as lower oxygen levels in bottom waters in Winterswijk and freshwater input and/or changes in salinity in the UK.

Intermittent hypoxia in sport nutrition, performance, health status and body composition.

Intermittent hypoxia refers to the discontinuous use of low oxygen levels in normobaric environment. These conditions can be reproduced in hypoxic tents or chambers while the individual is training in different physical activity protocols. Intermittent hypoxia can affect several body systems, impacting nutrition, physical performance, health status and body composition. Therefore, it is necessary to assess protocols, regarding time and frequency of exposure, passive exposure or training in hypoxia, and the simulated altitude. At the molecular level, the hypoxia-inducible factor-1α is the primary factor mediating induction of target genes, including vascular endothelial growth factor and erythropoietin. The goal of these molecular changes is to preserve oxygen supply for cardiac and neuronal function. In addition, hypoxia produces a sympathetic adrenal activation that can increase the resting metabolic rate. Altogether, these changes are instrumental in protocols designed to improve physical performance as well as functional parameters for certain pathological disorders. In addition, nutrition must adapt to the increased energy expenditure. In this last context, performing physical activity in intermittent hypoxia improves insulin sensitivity by increasing the presence of the glucose transporter GLUT-4 in muscle membranes. These changes could also be relevant for obesity and type 2 diabetes treatment. Also, the anorectic effect of intermittent hypoxia modulates serotonin and circulating leptin levels, which may contribute to regulate food intake and favor body weight adaptation for optimal sport performance and health. All these actions suggest that intermittent hypoxia can be a very effective tool in sports training as well as in certain clinical protocols.

Correlation between BMI and HB with Oxygen Saturation in Medical Students

Background: The bulk of oxygen in blood is normally transported as oxyhemoglobin. The amount of oxyhemoglobin is often expressed as percentage saturation (Spo2). Objective: Oxygen saturation is one of the vitals monitored in clinical practice and also the most important vital monitored in COVID-19patients since it’s the oxygen saturation which gets depleted in these patients. COVID pandemic has taken heavy toll on health and life of the people and since different people respond to COVID-19 differently so the response is multifactorial. The exposure to lower oxygen levels may have important clinical consequences, particularly in physiologic processes like respiratory drive, which are dependent on PO2 in the blood. Hence our aim is to study the effect of BMI and Hb on oxygen saturation (SPO2). Method: A descriptive cross-sectional study was conducted in Department of Physiology, SKIMS-Medical College. Data was collected by using self-administered questionnaire followed by anthropometric measurement. Body Mass Index (BMI) by Quetelet’s index and Haemoglobin (Hb) concentrations by Sahli’s method were assessed. Pulse oximetry was done to know the oxygen saturation.Results: The students with high BMI show negative correlation with oxygen saturation while as Hb with oxygen saturation shows positive correlation. These results have important clinical implications while treating patients with high BMI or low Hb

Routine postoperative admission to the neurocritical intensive care unit after microvascular decompression: necessary or can it be abandoned?

Postoperative neurocritical intensive care unit (NICU) admission of patients who underwent craniotomy for close observation is common practice. In this study, we performed a comparative analysis to determine if there is a real need for NICU admission after microvascular decompression (MVD) for cranial nerve disorders or whether it may be abandoned. The present study evaluates a consecutive series of 236 MVD surgeries performed for treatment of trigeminal neuralgia (213), hemifacial spasm (17), vagoglossopharyngeal neuralgia (2), paroxysmal vertigo (2), and pulsatile tinnitus (2). All patients were operated by the senior surgeon according to a standard protocol over a period of 12years. Patients were admitted routinely to NICU during the first phase of the study (phase I), while in the second phase (phase II), only patients with specific indications would go to NICU. While 105 patients (44%) were admitted to NICU postoperatively (phase I), 131 patients (56%) returned to the ward after a short stay in a postanaesthesia care unit (PACU) (phase II). Specific indications for NICU admission in phase I were pneumothorax secondary to central venous catheter insertion (4 patients), AV block during surgery, low blood oxygen levels after extubation, and postoperative dysphagia and dysphonia (1 patient, respectively). There were no significant differences in the distribution of ASA scores or the presence of cardiac and pulmonary comorbidities like congestive heart failure, arterial hypertension, or chronic obstructive pulmonary disease between groups. There were no secondary referrals from PACU to NICU. Our study shows that routine admission of patients after eventless MVD to NICU does not provide additional value. NICU admission can be restricted to patients with specific indications. When MVD surgery is performed in experienced hands according to a standard anaesthesia protocol, clinical observation on a neurosurgical ward is sufficient to monitor the postoperative course. Such a policy results in substantial savings of costs and human resources.

Transitions, challenges and trends in China's abalone culture industry

AbstractAbalone species are economically important shellfish in China's aquaculture industry. In 2020, China's abalone aquaculture production was 203,500 tonnes, accounting for nearly 90% of total global production. However, many problems have accompanied the rapid development of this industry, including a reduction in near‐shore space suitable for culture and the risk of exposure of farms to natural disasters such as typhoons and red tides. In addition, high temperatures and low oxygen levels resulting from global climate change are causing increased abalone mortality in summer. In this review, the culture patterns and characteristics used in different countries are compared with respect to larvae nurseries, intermediate juvenile culture and the grow‐out phase. Next, the transitions and challenges in China's abalone culture industry over the past 60 years are summarized. Finally, a coordinated land‐sea program for reducing solid waste emissions into the water and increasing carbon sinks is suggested based on the ‘Carbon Neutrality’ theory. Under the framework of the program, new facilities, technologies and models should be created to achieve increased mechanization and a greater understanding of the abalone aquaculture industry as soon as possible. This review provides references and data to support the scientific planning and mapping of China's abalone culture industry as well as the transition of China's perceived identity from a major fishery country to a strong fishery power with an awareness of environmental protection and resource use.

Anemia on Chronic Kidney Disease: The Role of Hypoxia-Inducible Factor Prolyl Hydroxylase Inhibitors

Anemia is one of the homeostatic abnormalities caused by chronic kidney disease and also frequently problem encountered in end-stage renal disease patients, regardless of the hemodialysis treatment. Anemia in chronic kidney disease significantly impairs kidney function, increases morbidity and mortality risk, and deteriorates the quality of life. Chronic kidney disease’s patients with anemia conditions are affected by numerous factors, including decreased production of endogenous erythropoietin, functional and absolute iron deficiency, and elevated hepcidin levels due to inflammation, particularly in hemodialysis patients. Treatment options for anemia in chronic kidney disease include exogenous erythropoietin and iron supplementation. A new mechanism known as the "hypoxia-sensing system" termed a mediator of erythropoietin synthesis, has been proposed to boost endogenous erythropoietin synthesis. The hypoxia-inducible factor activates specific gene expression and contributes to a physiological response to lower tissue oxygen levels. Chronic kidney disease’s patients who are contraindicated or are hyporesponsive to therapy with erythropoiesis-stimulating drugs may utilize this mechanism as an alternative.

Heat waves harm fish brains

Climate change is causing heatwaves to become longer, more frequent and just plain hotter. For many of us, dealing with oppressive heat comes with several unpleasant challenges, from profuse sweating to feeling tired and sluggish. Humans, however, are not the only ones suffering through unprecedented heatwaves in a warming climate. In a ground-breaking study by Anna Andreassen and her team at the Norwegian University of Science and Technology, the researchers investigated what happens to the brains of larval zebrafish (Danio rerio) during extreme heatwaves, particularly as temperatures approach the upper limit of their heat tolerance. For these small fish, the consequences of unbearable heat are far worse than becoming a little sweaty.Fish can only tolerate temperatures so high. At some point, they lose the ability to swim properly and assume the ‘belly up’ position (termed loss of equilibrium), an indicator of imminent death. For decades, biologists have wondered what happens in the body of fish at their upper temperature limit that prompts this behaviour. Andreassen and her team set out to solve this mystery by testing whether going belly up is caused by the brain not communicating properly with the rest of the body. This miscommunication is thought to occur because high temperatures stop nerve cells in the brain from functioning as they should. But first, the researchers needed a way to visualize the fish's brain activity at extremely high temperatures. Thanks to advances in genetic technology, they were able to study genetically modified zebrafish whose brains emit a fluorescent light when their neurons are active.The researchers gradually increased the water temperature in the tank and observed the nerve cell activity of the genetically modified zebrafish using a microscope that could detect fluorescent light. At their upper temperature limit (approximately 40.9°C), the fish's brains showed very little fluorescence, indicating that the nerve cells were largely inactive. At this temperature, the larval fish were also no longer responsive to stimuli, such as bright lights flickering in front of their eyes. Interestingly, when the water temperature was raised by only 0.5°C above the upper temperature limit, something unexpected happened – the whole brain lit up as if the fish were having a seizure! This seizure-like activity was a sign that the brain had become completely depolarized, meaning that its nerve cells were firing on all cylinders, but not in a controlled manner. As this seizure-like event occurred at temperatures only slightly higher than the upper temperature limit, the team concluded that this is not what causes fish to lose equilibrium. Rather, they suggest that impaired neuron activity at the upper temperature limit is the mechanism underpinning this dangerous phenomenon.The researchers decided to take their study one step further to determine why neurons stop working at the upper temperature limit. They had a hunch that high temperatures limit how much oxygen gets to the brain, which then impairs how its nerve cells function. Andreassen and her team repeated the heat ramping experiment, but this time at high, medium and low oxygen levels. They discovered that larvae exposed to high oxygen levels in the water did better at high temperatures than those in low oxygen; the fish had higher brain activity and recovered faster after being exposed to their upper temperature limit. Overall, these findings suggest that the amount of oxygen in the water plays an important role in controlling how the brain communicates with the body at extremely high temperatures. So, the next time you're sweating profusely in the midst of a summer heatwave, take a deep breath and be thankful that your brain function has remained intact.