To investigate the effect of rifle carriage on performance, physiological responses, power output and external work during a simulated biathlon competition in the field. Twenty well-trained biathletes (10 women) completed a simulated biathlon competition (women 3 × 1.9 km, men 3 × 2.4 km) twice, one trial while carrying the rifle (WR) and the other without rifle (NR) in a randomized counter-balanced order. Laps were separated by two simulated shootings, lasting 38.9 ± 8.2 s. Trials were separated by 30-min of active recovery. Heart rate and respiratory variables were measured throughout each trial. Furthermore, blood lactate concentration and ratings of perceived exertion were assessed after each lap. Power output and external work were estimated for both trials based on positional data. Overall roller-skiing speed was lower WR than NR (5.49 ± 0.47 vs. 5.69 ± 0.49 m∙s-1, p < 0.001), with largest differences during the uphill sections. No differences in physiological responses were found between WR and NR during laps or course sections (p > 0.05), but oxygen uptake and breathing frequency were higher WR than NR during the second simulated shooting (p < 0.05). Mean power output was slightly lower WR than NR; however, the participants performed more external work WR compared to NR due to the longer duration of the WR trial (both p < 0.05). Since elevated physiological markers may negatively impact standing shooting performance, biathletes should optimize their pacing strategies to maximize overall performance. In addition, rifle carriage increases external work through a lengthened skiing duration, which should be considered when planning and performing biathlon training.

Parasympathetic activity is reduced in chronic hypoxia, but the underlying mechanism(s) are unclear. We investigated whether (i) arterial chemoreflex activation, (ii) increased pulmonary ventilation and/or (iii) pulmonary stretch, (iv) hypocapnia resulting from increased ventilation or (v) hypovolemia due to plasma volume contraction reduce parasympathetic activity in chronic hypoxia. In 13 lowlanders (8M/5F), we administered β-adrenergic blockade (intravenous propranolol) to isolate parasympathetic control of HR and thus use HR as a reciprocal index of parasympathetic activity, first at sea level (SL) and then after 9-12days of exposure to high altitude (HA, 3800m). Under β-adrenergic blockade, HR was 9.3±6.5bpm higher at HA than at SL (P<0.001), supporting parasympathetic withdrawal in chronic hypoxia. This HA-induced HR increase remained unchanged when (i) the arterial chemoreflex was inhibited by pure oxygen breathing (P=0.083) but decreased when (ii) pulmonary ventilation was matched between SL and HA by paced breathing (P=0.031). Performing apnoeas abolishing differences in pulmonary stretch (iii) did not reduce the HA-induced HR acceleration (P=0.275), whereas (iv) increasing end-tidal CO2 partial pressure to counteract hypocapnia at HA further enhanced it (P=0.006). Restoring blood volume at HA to SL values by saline infusion (v) also failed to reduce the HA-induced HR acceleration (P=0.813). Our findings support a contribution of increased ventilation, but not of arterial chemoreflex activation, hypocapnia or hypovolemia, to the parasympathetic withdrawal associated with chronic hypoxia. That performing apnoea failed to reduce the HA-induced elevation in HR furthermore indicates that the increased ventilation reduces parasympathetic activity via mechanisms other than pulmonary stretch. KEY POINTS: Chronic hypoxia reduces parasympathetic activity, but the underlying mechanisms remain unclear. At sea level and after 9-12days of sojourn at high altitude, we used β-adrenergic blockade to isolate parasympathetic control of the heart, so that heart rate could be used as a reciprocal index for parasympathetic activity. Heart rate under β-adrenergic blockade was higher at high altitude than at sea level, supporting parasympathetic withdrawal in chronic hypoxia. Matching ventilation between sea level and high altitude reduced the high altitude-induced heart rate acceleration, indicating that the increased pulmonary ventilation in chronic hypoxia contributes to parasympathetic withdrawal. Conversely, the high altitude-induced heart rate acceleration was not reduced by inhibition of the arterial chemoreflex, or removal of hypoxia-indued hypocapnia or hypovolemia, thus not supporting these as mechanisms of reduced parasympathetic activity in chronic hypoxia.

Early detection of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) remains a critical challenge in COPD management. This study introduces the Bora Vital Sign Standard Score (BVS3), a novel unsupervised statistical score that predicts AECOPD using vital signs collected at home through remote patient monitoring, and retrospectively evaluates its predictive performance in identifying AECOPD ahead of clinician-defined episodes. The eMEUSE-SANTÉ clinical trial (NCT04963192) involved 220 COPD patients who were remotely monitored for six months using a CE-certified (Class IIa) connected wristband measuring oxygen saturation (SpO₂), breathing rate (BR) and heart rate (HR). A total of 42 physician validated exacerbations of COPD with no missing remote monitoring data were documented in 39 patients at a general hospital. Continuous 24-hour monitoring of vital signs using a connected wristband was well accepted over the long term, with a median adherence of 86% indicating strong patient compliance. The BVS3 risk score achieved excellent predictive performance, with an AUC of 0.88 (95% CI 0.83 – 0.92) for moderate and severe AECOPD combined. The BVS3 score anticipated exacerbations an average of 4.4 ± 3.1 days before clinical confirmation, with an overall accuracy of 84.8% and sensitivity of 74% with 85% specificity. Individual Z-scores for heart rate (z-HR), breathing rate (z-BR) and oxygen saturation (z-SpO2) showed specific predictive capabilities for moderate and severe events, yielding AUCs of 0.83, 0.82 and 0.71 respectively, but with inferior performances compared with the combination of the 3 vital signs Z-scores. These results demonstrate that integrating passive remote monitoring with unsupervised statistical modeling provides a scalable, high-compliance approach to AECOPD detection. The interpretable BVS3 risk score achieves good accuracy and anticipation for AECOPD prediction with minimal patient burden. By enabling earlier intervention, this end-to-end digital solution could significantly improve patient outcomes through proactive disease management.

Abstract For centuries, infectious diseases have represented a leading cause of global morbidity and mortality, with high transmissibility posing persistent public health challenges. Because early physiological changes often precede overt clinical symptoms, continuous physiological monitoring may provide opportunities for earlier recognition of illness and timely intervention. In this study, we developed and evaluated a wireless wearable device capable of measuring microvascular tissue oxygen saturation, respiratory rate, respiratory rhythm, breathing depth, heart rate, and pulse strength. Device performance was assessed in a clinical study involving healthy participants performing breath-holding, paced breathing, and mild hypercapnia tasks. Breathing rate and heart rate derived from the wearable device were compared with corresponding measurements obtained from commercial physiological monitoring systems. Chest tissue oxygen saturation measured by the wearable device was additionally evaluated alongside peripheral blood oxygen saturation measured using a commercial pulse oximeter. Across all tasks, wearable-derived breathing rate and heart rate demonstrated strong agreement with commercial systems, with small biases (≤0.19 breaths/min for breathing rate and ≤0.47 beats/min for heart rate). Chest tissue oxygen saturation exhibited distinct and rapid responses during breath-holding and mild hypercapnia, whereas peripheral oxygen saturation showed delayed or inconsistent changes. During breath-holding, changes in tissue oxygenation preceded peripheral desaturation by approximately 10 seconds. Collectively, these findings demonstrate the feasibility of the wearable device for real-time, continuous monitoring of cardiorespiratory parameters and microvascular tissue oxygenation, and suggest that tissue-level oxygenation measurements may provide complementary physiological information relevant to early respiratory stress in both general health and infectious disease research contexts.

Early detection of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) remains a critical challenge in COPD management. This study introduces the Bora Vital Sign Standard Score (BVS3), a novel unsupervised statistical score that predicts AECOPD using vital signs collected at home through remote patient monitoring, and retrospectively evaluates its predictive performance in identifying AECOPD ahead of clinician-defined episodes. The eMEUSE-SANTÉ clinical trial (NCT04963192) involved 220 COPD patients who were remotely monitored for six months using a CE-certified (Class IIa) connected wristband measuring oxygen saturation (SpO₂), breathing rate (BR) and heart rate (HR). A total of 42 physician validated exacerbations of COPD with no missing remote monitoring data were documented in 39 patients at a general hospital. Continuous 24-hour monitoring of vital signs using a connected wristband was well accepted over the long term, with a median adherence of 86% indicating strong patient compliance. The BVS3 risk score achieved excellent predictive performance, with an AUC of 0.88 (95% CI 0.83 - 0.92) for moderate and severe AECOPD combined. The BVS3 score anticipated exacerbations an average of 4.4 ± 3.1 days before clinical confirmation, with an overall accuracy of 84.8% and sensitivity of 74% with 85% specificity. Individual Z-scores for heart rate (z-HR), breathing rate (z-BR) and oxygen saturation (z-SpO2) showed specific predictive capabilities for moderate and severe events, yielding AUCs of 0.83, 0.82 and 0.71 respectively, but with inferior performances compared with the combination of the 3 vital signs Z-scores. These results demonstrate that integrating passive remote monitoring with unsupervised statistical modeling provides a scalable, high-compliance approach to AECOPD detection. The interpretable BVS3 risk score achieves good accuracy and anticipation for AECOPD prediction with minimal patient burden. By enabling earlier intervention, this end-to-end digital solution could significantly improve patient outcomes through proactive disease management.

Functional ultrasound imaging (fUSI) is an emerging technology for assessing functional brain activity. To date, functional ultrasound without contrast agents has only been applied to human imaging during surgery with the skull removed or in neonates through a fontanel window. Here, we showcase a proof-of-concept study of contrast-free transcranial fUSI (tfUSI) through adult skulls. To achieve the high sensitivity and image quality required for tfUSI, we utilize several techniques including compound Barker coded excitation to boost signal-to-noise ratio, adaptive motion compensation and a head fixation device to minimize the effects of motion, and an eigen-based filtering approach to separate blood flow from tissue clutter. We assessed cerebrovascular reactivity induced by a breath hold by measuring cerebral blood volume with power Doppler imaging. We targeted the vasculature surrounding the midbrain in 13 healthy adult volunteers during a six minute task of alternating free breathing and breath holding periods. We showed that the power Doppler signal was correlated to the breath hold task ($\rho = 0.53 \pm 0.08$) and oxygen saturation ($\rho = 0.71 \pm 0.10$). Correlation coefficients were statistically significant for each subject (one-tailed $t$-test, $\alpha =0.01$). We also observed delayed vasodilation response in the power Doppler signal that reflected the expected delayed oxygen saturation drop from the breath hold. Delays to maximal signal were $47.69 \pm 23.7$ s for the first breath hold and $52.31 \pm 18.0$ s for the second breath hold. Our results demonstrate the utility of tfUSI for evaluating cerebrovascular reactivity and pave the way for further development to enable assessment of neural activation.

Methemoglobinemia induced by dapsone, hydroxychloroquine, and rifampin combination for post-treatment Lyme disease syndrome: A case report.

Background/Objectives: Hyperbaric Oxygen Therapy (HBOT) involves breathing oxygen at pressures greater than atmospheric levels and is used to treat diverse clinical conditions. However, little is known about the lived experiences and perceived needs of patients undergoing scheduled treatment in multiplace hyperbaric chambers, where nurses play a key role in support, safety, and communication. This study aimed to explore the perceptions, expectations, and needs of patients receiving scheduled HBOT sessions in a multiplace chamber in a hospital setting. Methods: A qualitative phenomenological design was used. Participants were recruited consecutively among adults who had completed at least 10 HBOT sessions and demonstrated adequate cognitive function. Individual semi-structured interviews were conducted between January and March 2023 in locations chosen by participants. Interviews were audio-recorded, transcribed, and validated by participants. Results: Twelve participants (eight men, four women; aged 25-84 years) were included. Four thematic areas emerged: (1) Biopsychosocial lived experiences, including initial uncertainty, physical discomfort such as ear pressure or mask-related issues, and progressive recognition of therapeutic benefits. (2) Interpersonal relationships, highlighting trust, security, and emotional support provided mainly by nurses. (3) Communication experiences, with participants expressing satisfaction but requesting clearer, earlier information on procedures, risks, and expected sensations. (4) Structural and organizational factors, where transportation logistics and treatment scheduling were significant sources of fatigue and discomfort. Conclusions: Patients valued HBOT and perceived notable health improvements, while identifying specific unmet informational and organizational needs. These findings suggest the importance of nurse-led educational interventions to enhance preparation, reduce anxiety, and optimize patient experience during HBOT.

BackgroundEarly detection of hypoxia in the emergency room may reduce complications. Breath sounds can be evaluated immediately. Our research endeavors to investigate the relationship between breath sounds and oxygen demand.MethodsWe recruited patients from the emergency department. Respiratory sounds in four locations were recorded with an electronic stethoscope and classified into normal, wheezing, or crackles. The primary outcome was increased oxygen demand (IOD) in the emergency room, and the secondary outcome was intensive care unit (ICU) admission. The prediction model was evaluated by logistic regression model.ResultsOverall, 2,216 patients were recruited, and 171 (7.7%) had IOD. Through multivariable logistic regression, independent predictive factors for IOD were age (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.01–1.03), lung cancer (OR: 3.56, 95% CI: 1.99–6.36), triage respiratory rate (OR: 1.02, 95% CI: 1.00–1.04), triage oxygen saturation (OR: 0.95, 95% CI: 0.92–0.98), and wheezing (OR: 2.87, 95% CI: 1.31–6.29). The area under receiver operating characteristic curve (AUROC) for IOD was 0.791 (95% CI 0.756–0.8273. Age (OR: 1.02, 95% CI: 1.00–1.03), coronary artery disease (OR: 3.00, 95% CI: 1.82–4.95), chronic obstructive pulmonary disease (aOR = 2.53, 95% CI = 1.32–4.84) and triage oxygen saturation (aOR = 0.96, 95% CI = 0.93–0.99) were significantly associated with increased ICU admission.ConclusionWheezing, together with other bedside-available predictors, was independently associated with increased oxygen demand. This finding may facilitate early risk stratification and optimize oxygen resource allocation at the initial encounter, before laboratory or imaging examinations are available. Through voice-print analysis and artificial intelligence, future studies are warranted to further explore the predictive potential of breath sounds.

Asthma is a chronic health problem that significantly impacts physical and psychological conditions, especially during emergencies in the emergency department (ER). Anxiety in asthma patients can worsen clinical conditions and prolong recovery time if not promptly addressed. This study aims to assess the effectiveness of Spiritual Emotional Freedom Technique (SEFT) as a non-pharmacological technique to reduce anxiety in asthma patients in the emergency department of Soeradji Tirtonegoro Regional Hospital, Klaten. This study was conducted descriptively through a case study of one asthma patient with anxiety disorders, using the Hamilton Anxiety Rating Scale (HARS) instrument before and after the SEFT intervention. The SEFT implementation was structured for 15 minutes, which included the stages of setup techniques, tune-in, and tapping on the body's energy points. The results of the measurements and assessments were analyzed using a nursing care approach. The measurement results showed a decrease in the patient's anxiety score from 17 (moderate) to 14 (mild) after SEFT, accompanied by clinical improvements such as respiratory rate stability and increased psychological comfort. Family support during therapy plays an important role in accelerating the reduction of anxiety and patient recovery. Based on the results and discussion, it can be concluded that SEFT is effective as a psychological intervention to reduce anxiety in asthma patients in emergencies, and can be integrated with breathing education and oxygen saturation monitoring for optimal results.

Gas exchange dynamics and responses to exercise in chronic thromboembolic pulmonary hypertension.

BACKGROUND: Inhalation of technologically generated singlet oxygen is used empirically in fitness and sports medicine and is proposed for integration into clinical practice. However, the mechanisms of action and safety of this treatment remain unclear. AIM: The study aimed to evaluate the systemic effects of long-term exposure to an air mixture enriched with singlet oxygen in vivo. METHODS: The study was conducted on eight female Wistar rats (200–220 g) which were kept in a barrier animal facility. The experimental group (singlet oxygen, n = 4) received an air mixture enriched with singlet oxygen for free breathing three times a day for 40 minutes for 4 months in an individually ventilated cage via the SmartFlow ventilation system. A custom-built device employing a novel photocatalytic method was used to generate singlet oxygen. Intact rats (n = 4) were used as controls. Body weight, hematological parameters, plasma total antioxidant and pro-oxidant capacities, tissue malondialdehyde levels, and organ histology were evaluated. RESULTS: The singlet oxygen group showed no signs of general toxicity, such as hair loss, inflammation of visible mucous membranes, diarrhea, or behavioral stress. There were no weight differences between groups. An increase in hemoglobin concentrations was observed among the hematological parameters (p = 0.028). No differences were detected in plasma total antioxidant and pro-oxidant capacities. However, lipid peroxidation, as indicated by malondialdehyde levels in liver and kidney tissues, was significantly lower than the baseline values of the intact group (p = 0.043 and p = 0.029, respectively). No histopathological changes were observed in the nasal ciliated epithelium or the parenchyma of the lungs, liver, kidneys, heart, spleen, and thymus. CONCLUSION: The in vivo study demonstrated the safety of long-term inhalation of an air mixture containing singlet oxygen. In the absence of histological changes, trends in lipid peroxidation levels suggest that tissues and organs are adapting to breathing air enriched with singlet oxygen. These systemic changes may result from the pathophysiological mechanism of remote preconditioning.

Intriguing analogies between the nickelates and the cuprates provide a promising avenue for unraveling the microscopic mechanisms underlying high-${T}_{c}$ superconductivity. While electron correlation effects in the nickelates have been extensively studied, the role of electron-phonon coupling (EPC) remains highly controversial. Here, by taking pristine ${\mathrm{LaNiO}}_{2}$ as an exemplar nickelate, we present an in-depth study of EPC for both the nonmagnetic (NM) and the $C$-type antiferromagnetic ($C$-AFM) phases using advanced density functional theory methods without invoking $U$ or other free parameters. The weak EPC strength $\ensuremath{\lambda}$ in the NM phase is found to be greatly enhanced ($\ensuremath{\sim}4\ifmmode\times\else\texttimes\fi{}$) due to the presence of magnetism in the $C$-AFM phase. This enhancement arises from strong interactions between the flat $\mathrm{Ni}\text{\ensuremath{-}}3d{z}^{2}$ bands and the low-frequency phonon modes associated with Ni and La vibrations, rather than solely from the high-frequency oxygen breathing modes. The resulting phonon softening is shown to yield a distinctive kink in the electronic structure around 15 meV, which would provide an experimentally testable signature of our predictions. Our study highlights the critical role of local magnetic moments and EPC in the nickelate.

There are increasing anecdotal reports of in-water recompression in freedivers who surface with neurological symptoms, likely suffering from decompression illness (DCI). Given the remote locations where many cases occurred, divers often struggled to access medical care, including the gold-standard hyperbaric oxygen treatment (HBOT), thus resorting to in-water recompression (IWR). Currently, IWR guidelines have only been discussed for scuba and surface supplied divers in specific scenarios, with protocols prescribing oxygen breathing at depths ≤ 9 metres maximum for around 1-3 hours. We conducted detailed interviews with six competitive freedivers on signs, symptoms, management, and resolution of 13 cases of DCI. We additionally requested records of medical evaluation and treatment, with their consent. Three cases were suggestive of decompression sickness, six were consistent with arterial gas embolism, and four were ambiguous. Six cases were treated with IWR for 20-90 min at 5-25 metres with partial to complete resolution of symptoms. Four of these cases received HBOT afterwards. One diver reported significant permanent disability. Divers made several regimen changes after these incidents, including staying well-hydrated, reducing lung-packing, slowing their ascent rate, and/or employing prophylactic IWR when diving beyond a specified depth. Given the remote locations of many incidents, freedivers often faced challenges in accessing HBOT. Self-treatment with IWR was widely used, either as a bridge to HBOT or as a standalone remedy. IWR poses potential risks, especially at the deeper depths reported in this study. This treatment modality is being utilised sometimes without medical oversight and recommended guidelines for IWR for freedivers should be developed.

Asthma is a chronic respiratory disease that requires continuous monitoring and timely management to prevent life threatening exacerbations. Despite the availability of treatment options, poor self-management and delayed symptom recognition remain major causes of hospitalizations among asthma patients. This research introduces AERO, an AI integrated wearable asthma management kit designed to enhance self-monitoring, awareness, and early response among asthma patients. The device continuously collects physiological data, including breathing rate, oxygen saturation, and cough frequency, using embedded sensors. The integrated AI module interprets these patterns to provide personalized education, predict possible asthma attacks, and issue real time alerts and medication reminders. Furthermore, a novel Asthma Classification and Control Scale (ACCS) has been developed to categorize patients’ condition severity based on the collected data. A survey-based evaluation was conducted with 110 asthma patients and 45 physicians to assess user needs, design preferences, and perceived effectiveness of the device. The findings suggest that AERO has the potential to improve symptom recognition, medication adherence, and patient education, leading to better asthma control and quality of life. This research contributes to the development of AI driven healthcare wearables and offers a scalable framework for chronic disease management.

Previous findings reported increased toxicity of FLASH radiotherapy (FLASH) delivered under supplemental oxygen but failed to quantify the change in magnitude of the FLASH sparing effect. This study investigated the impact of oxygen breathing on normal tissue complication probability (NTCP) following FLASH and conventional radiotherapy (CONV) using murine models of acute gastrointestinal and skin toxicity. Tumour-free C57BL/6 and BALB/c mice received whole-abdominal or skin irradiation, respectively, using either CONV or FLASH. Dose escalation was performed under air- and oxygen-breathing in both models to determine NTCP curves. The FLASH dose modifying factor (DMF) was derived as the dose ratio at 50% NTCP. Changes in tissue oxygenation, going from air- to oxygen-breathing, were measured in vivo using oxygen sensing by phosphorescence quenching. Abdominal irradiation under air breathing showed a significant FLASH sparing effect, with a mean DMF of 1.14. This effect was abolished under oxygen breathing, with a mean DMF reduced to 1.00. In contrast, skin irradiation under air breathing demonstrated a strong FLASH sparing effect, with a mean DMF of 1.42, which was largely preserved under oxygen breathing (mean DMF = 1.40). Oxygen breathing markedly increased tissue oxygenation in both the intestine and skin. Maintaining of the FLASH sparing effect under increased oxygenation is tissue dependent. Our findings indicate potential difference in CONV and FLASH oxygen enhancement ratio (OER) curves. By conducting dose escalation experiments in animal models we provided first quantification of change in magnitude of FLASH sparing effect under increased tissue oxygenation.

The increasing demand for efficient patient monitoring systems in healthcare and the growing need for remote monitoring, particularly post-pandemic, emphasise the importance of tracking critical parameters such as urine output, blood oxygen saturation, breath rate, and blood pressure. Urine output, a key indicator of kidney function and medical treatment response, is traditionally assessed manually, posing a significant burden on hospital staff and caregivers. Addressing this, our system facilitates continuous, accurate monitoring of urine output, enhancing patient care and healthcare efficiency. We developed a smartphone application leveraging capacitive sensors and a Wi-Fi-enabled control unit, enabling remote monitoring of urine bag volumes. The system alerts when bags are empty for extended periods or full, this is validated through experiments with volumes ranging from 100 to 1000 mL.The corresponding variations in sensor output voltage confirmed the accuracy of the system. To secure patient data, we incorporated AES-256 encryption with dynamic key generation using patient-specific IDs and OTP-based access control, ensuring data privacy and compliance with healthcare regulations. Our approach offers several advantages: ease of attachment to standard urine bags, non-invasiveness, reusability of bags, and remote monitoring through the mobile application. This innovation automates urine output monitoring, secures patient data, reduces the workload of intensive care nurses, and enhances patient care through precise and continuous monitoring. Unlike existing devices that rely on customised containers or short-range Bluetooth transmission, our system is compatible with standard urine bags, employs cost-effective capacitive copper-tape sensors, and integrates AES-256 encryption with dynamic key generation and OTP-based access control for robust data security. These unique features make the system functionally novel, technically secure, and highly practical for deployment in both hospital and home settings.

Pancreatic cancer-induced cachexia drives co-morbidities that result in a poor quality of life. To expand understanding of the effects of cachexia on the brain here, for the first time, we used noninvasive oxygen enhanced (OE) multispectral optoacoustic tomography (MSOT) to evaluate the ability of the brain vasculature to respond to oxygen breathing in an established xenograft model of pancreatic cancer-induced cachexia. Studies were performed with mice bearing cachexia inducing Pa04C tumors, non-cachexia inducing Panc1 tumors and non-tumor bearing mice. OE-MSOT identified a reduced oxygen carrying capacity in the brain vasculature of mice with cachexia inducing Pa04C tumors, compared to non-tumor bearing mice, and mice with non-cachexia inducing Panc1 tumors. Brain volumes, quantified in mice with MSOT, were significantly reduced in Pa04C tumor-bearing mice compared to non-tumor bearing mice. Our data have identified the inability of brain vasculature to increase oxygenation in response to oxygen breathing in cachectic mice as a new mechanism that may contribute to cachexia-induced morbidity.

BackgroundIntrauterine lung development is a complex process. Little is known regarding developmental breathing patterns of infants from delivery to discharge. In this study, we analyze developmental changes in work of breathing indices and oxygen saturation between healthy preterm and term infants at discharge.MethodsA prospective, observational study of healthy term infants at a single center nursery. Respiratory Inductive Plethysmography and pulse oximetry were studied in the supine position, between 12 and 48h of birth. Comparative analysis was performed with data from our study of premature infants without BPD.ResultsThe study included 63 infants (32 premature and 31 full term). Work of breathing was increased in term infants compared to preterm infants at discharge (Mean phase-angle, Φ ± SEM; Term: 73 ± 5° vs Preterm: 49 ± 7°; p = 0.017). Term infants had lower mean oxygen saturation (Term: 95 ± 0.42% vs Preterm: 97 ± 0.32%; p < 0.001), respiratory rate (Term: 56 ± 2.99br/min vs Preterm: 67 ± 2.55br/min; p < 0.008), and heart rate (Term: 130 ± 2.4bpm vs Preterm: 158 ± 1.8bpm; p < 0.0001) compared to preterm infants at discharge.ConclusionPreterm infants at discharge demonstrated more efficient thoracoabdominal synchrony and higher oxygen saturation than term infants. These findings suggest that preterm infants develop adaptive respiratory strategies in response to early and prolonged extrauterine respiratory demands, which confer physiological advantages despite structural immaturity. The data could influence post-discharge monitoring of preterm infants.

Femoral head avascular necrosis (AVN) is a common orthopaedic condition that occurs when intraosseous microcirculation is compromised. Hyperbaric oxygen therapy (HBOT) increases tissue oxygen concentration, reduces oedema, stimulates angiogenesis, lowers intraosseous pressure, and enhances microcirculation. The aim of this study was to evaluate the effectiveness of HBOT in early femoral head AVN based on magnetic resonance imaging (MRI) findings. A total of 37 hips from 25 patients with Ficat Stage 1-2 femoral head AVN, followed between 2018 and 2021 and receiving HBOT at Kayseri City Training and Research Hospital, were retrospectively included. Thirty HBOT sessions of 90 minutes each were administered at 243 kPa pressure (2.4 atmospheres absolute) with 100% oxygen breathing, along with a weight-bearing restriction protocol. There were 20 females and five males. The mean (standard deviation) age was 46.9 (9.5). In pre-treatment MRI imaging, the mean lesion size was 29.87 (22.64) cm³ in 20 right hips and 28.84 (14.95) cm³ in 17 left hips (P = 0.183). At the second month after treatment, the lesion size was 12.39 (11.26) cm³ in 20 right hips and 21.81 (13.56) cm³ in 17 left hips (P < 0.001). The mean pre-post differences for the right and left hips was 17.48 (21.15) cm³ and 7.02 (5.95) cm3 respectively (both P < 0.001). Femoral head AVN is a progressive disease, with femoral head collapse exceeding 40% in a five-year follow-up. This study demonstrated a reduction in lesion size associated with HBOT in early stage femoral head AVN. In our opinion, HBOT is an integral part of the treatment for early-stage femoral avascular necrosis.