Predictors Of Hypoxia Research Articles

Exploring Selenoprotein P in Liver Cancer: Advanced Statistical Analysis and Machine Learning Approaches.

Selenoprotein P (SELENOP) acts as a crucial mediator, distributing selenium from the liver to other tissues within the body. Despite its established role in selenium metabolism, the specific functions of SELENOP in the development of liver cancer remain enigmatic. This study aims to unravel SELENOP's associations in hepatocellular carcinoma (HCC) by scrutinizing its expression in correlation with disease characteristics and investigating links to hormonal and lipid/triglyceride metabolism biomarkers as well as its potential as a prognosticator for overall survival and predictor of hypoxia. SELENOP mRNA expression was analyzed in 372 HCC patients sourced from The Cancer Genome Atlas (TCGA), utilizing statistical methodologies in R programming and machine learning techniques in Python. SELENOP expression significantly varied across HCC grades (p < 0.000001) and among racial groups (p = 0.0246), with lower levels in higher grades and Asian individuals, respectively. Gender significantly influenced SELENOP expression (p < 0.000001), with females showing lower altered expression compared to males. Notably, the Spearman correlation revealed strong positive connections of SELENOP with hormonal markers (AR, ESR1, THRB) and key lipid/triglyceride metabolism markers (PPARA, APOC3, APOA5). Regarding prognosis, SELENOP showed a significant association with overall survival (p = 0.0142) but explained only a limited proportion of variability (~10%). Machine learning suggested its potential as a predictive biomarker for hypoxia, explaining approximately 18.89% of the variance in hypoxia scores. Future directions include validating SELENOP's prognostic and diagnostic value in serum for personalized HCC treatment. Large-scale prospective studies correlating serum SELENOP levels with patient outcomes are essential, along with integrating them with clinical parameters for enhanced prognostic accuracy and tailored therapeutic strategies.

Validity Analysis of Neck Circumference as a Screening Test for Hypoxia Occurrence in Patients Undergoing Sedative Endoscopy.

This study was performed to check the validity of and propose a cutoff point for measuring the neck circumference for screening hypoxia occurrence in patients undergoing sedative endoscopy. Data were collected from 168 patients who visited the Endoscopy Center of G University Hospital between 27 April 2020 and 12 June 2020 to undergo sedative endoscopy. Hypoxia occurrences were measured using sleep questionnaires (STOP-BANG and Berlin questionnaires), and the neck circumference measurements of the patients were compared. Neck circumference as a predictor of hypoxia and its sensitivity and specificity according to the cutoff values were high; thus, it is a valid screening test for hypoxia in patients undergoing sedative endoscopy. The most appropriate cutoff values for sitting neck circumference and lying neck circumference in men were 40.5 and 40.3, respectively, and those for women were 35.3 and 35.8, respectively. Hypoxia can be predicted in patients undergoing sedative endoscopy by measuring their neck circumference.

295: Angiogenic factors as biomarkers for fetal wellbeing during delivery

Four million newborns die at delivery, and the main factor associated with neonatal death or long term neuro-developmental disabilities is hypoxia. Available predictors of hypoxia during labor such as CTG and fetal scalp blood are rather poor, with a low positive predictive value. Levels of angiogenic factors such as VEGF (Vascular Endothelial Growth Factor), PlGF (Placental Growth Factor), Ang-1 (Angiopetin-1) and Ang-2 (Angiopoetin-2) are known to be regulated by hypoxia and affected by an insufficiently working placenta. If they differ during delivery in relation to acute fetal asphyxia, is unknown. Aim of the study: To investigate if different angiogenic factors during the delivery and if these factors might be predictors of fetal wellbeing. 100 newborns, delivered at Soder Hospital in Stockholm, were included. They were classified as not healthy if one or more of the following criteria were present: 1) pH ≤7, 10, 2) Apgar < 7, at 5 minutes, 3) BE >-12 and 4) transfer to NICU. CB (Cord Blood) and AF (Amniotic Fluid) was collected and immediately frozen at -70°C. Gene expression and the level of the factors in CB and AF were analyzed by qPCR. A correlation between the gene expressions of both Ang-2 and PlGF in CB and non-healthy newborns was found (Folder change nonhealthy /healthy was 2, 03 for Ang-2 and 1, 44 for PlGF in CB). No significant correlation was seen between gene expression of Ang-1 and VEGF. When analyzing the protein level of angiogenic factors in CB and AF, the level of VEGF in AF showed a significant correlation with a non-healthy newborn. Our results show an upregulation of the gene expression of Ang-2 and PlGF in the not-healthy newborns. A correlation between the protein level of VEGF in AF and hypoxia at delivery was found. Future projects will evaluate if these angiogenic factors could be used as predictors of fetal hypoxia during labor.

Characteristics of adenine nucleotides content in acute hypoxia by mathematical analysis methods

Oxygen starvation is observed in a variety of pathological states and serves as one of the urgent problems in medicine. A decrease in oxygen supply to tissues is accompanied by the inhibition of metabolic processes (primarily of energy metabolism), which impairs functional activity of the brain. The main source of energy for brain is adenosine triphosphate (ATP). It was shown that the components of adenylate pool can be used as early predictors of hypoxia. Aim of the study: the aim of our study was analysis of adenosine triphosphate (ATP) and adenosine monophosphate (AMP) experimental concentrations and integral coefficient K= in intact animals brain tissue and in disturbances of the oxygen regime by methods of mathematical analysis, as well as detection of some regularity in the character of their changes under the impact of hypoxia for the assessment and prediction of direction of production and utilization energy in metabolic pathways. Methodology: in this study empirical dependencies and criteria of statistical significance of mathematical modeling of quantitative relation between specified brain nucleotide stock indicators for the assessment and prognostication of brain energy state in extreme conditions were used. Results and area of their application: The use of empirical dependencies methods allowed to create multiregression models, subtly enough to unite experimental indicators ATP and AMP in hypobaric hypoxia and ischemia with different-term exposure. Obtained models can be used for prognostication of ATP and AMP concentrations in disturbances of the oxygen regime in a short or over a long period of time, as well as to receive information of indicator K= changing depending on brain hypoxia. Conclusion: functional dependencies are presented in this study to analyze shape, closeness and stability of relations between adenine nucleotides characterizing coupling of production and utilization energy processes, and also to predict the direction of these processes under hypoxic condition.

Oral Intake as a Sign of Hypoxia in Infants with Bronchiolitis

Source: Corrard F, de LaRocque F, Martin E, et al. Food intake during the previous 24 h as a percentage of usual intake: a marker of hypoxia in infants with bronchiolitis: an observational, prospective, multicenter study. BMC Pediatrics. 2013; 13(1): 6– 12; doi: 10.1186/1471-2431-13-6Investigators from France coordinated efforts to study whether food intake in the preceding 24 hours could serve as an indicator of hypoxia in infants with bronchiolitis. Infants from birth to 6 months old with symptoms of rhinorrhea, cough, dyspnea, and expiratory sounds were recruited from 18 community pediatrics offices in the Paris area during the winter months of 2006 to 2009. Because of the difficulty in assessing intake, infants who were breastfed were excluded. Food intake during the previous 24 hours (24h FI) was calculated as the sum of bottle and spoon feeding and expressed as a percentage of usual 24-hour intake. Infants were examined for signs of respiratory distress (nasal flaring, retractions, respiratory rate, cyanosis, and observed or parental reports of respiratory pauses). Only after these data had been recorded was transcutaneous pulse oximetry (SpO2) measured. The highest stable value of SpO2 was recorded. The main outcome of the study was the association between the 24h FI and other clinical signs or respiratory distress, as predictors of a SpO2 <95% in study infants.During the study period, 171 infants with a mean age of 1.6±3.7 months were recruited. Assessment occurred between the 1st and 6th day (average 2 days) after the onset of chest sounds as reported by the parents. The 24h FI was <50% in 14% of infants, 50% to 70% in 26% of infants, and >70% in 60% of infants. Nasal flaring was seen in 2% of study infants, suprasternal retractions in 15%, intercostal retractions in 25%, subcostal retractions in 30%, respiratory rate ≥50/min in 43%, respiratory rate ≥60/min in 23%, and cyanosis was observed in 5 infants.SpO2 was <95% in 9% of study infants and <90% in 2. The average SpO2 in infants whose 24h FI was ≤50% was 95.5% versus 98.1% in infants whose 24h FI was ≥50% of their usual intake (P < .001). If the 24h FI was ≥50% of the usual amount, the likelihood that oxygen saturation would be >95% was 96%. The sensitivity of 24h FI as a predictor of SpO2 <95% was 60% and the specificity was 90%. The odds ratio (OR) of having a SpO2 <95% when the 24 FI was <50% was 13.8, a higher OR than any of the other clinical signs evaluated.The authors conclude that measurement of 24h FI may be useful for identifying hypoxia in infants with bronchiolitis.Dr Webber has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.Bronchiolitis causes a significant disease burden in pediatric populations worldwide. Diagnosis is based primarily on clinical findings, and routine recommendations call for supportive care.1 Scoring systems provide useful objective predictors of clinical severity; however, a recent study showed only limited utility in predicting hypoxia.2 Even the utility of hypoxia as a marker of disease severity is not entirely clear, as hypoxia is variously defined as an oxygen saturation between 90% and 95% and has not consistently been shown to predict clinical severity in bronchiolitis.3 Clinicians continue to look for reliable objective markers to predict which patients will progress to severe disease and require hospitalization.The authors of the current study attempt to establish the relationship of oral intake (a common feature of pediatric assessment and history taking) to oxygen saturation. A 24h FI <50% was a better predictor of hypoxia than any other clinical sign assessed.One limitation of this study was the exclusion of breastfed infants. The investigators eliminated this population due to the inability to determine an objective quantity of food intake. However, as encouraging breastfeeding is a major thrust of infant health care, exclusively bottle-fed infants represent a limited portion of the pediatric population.4Despite this limitation, the current study describes a relationship between food intake and oxygenation status in infants <6 months old with bronchiolitis. Although investigators focused analysis and discussion on the need for hospitalization, their findings could prove potentially useful for phone triage services and anticipatory guidance. Oral intake is historical information and does not require a physical examination. A way of assessing oral intake among breastfed infants would be important and might simply be an estimate of the length of a nursing session as compared to the usual duration.While diminished food intake is a well-recognized concomitant of cardiopulmonary diseases in children, quantification of this clinical sign represents a new, albeit imperfect, twist to access the severity of disease. We look forward to its validation in a more diverse cohort of infants with additional objective outcome measures.