Oxygenation Status Research Articles

Hospital-Acquired Pressure Injuries in Adults With Prone Positioning Using Manual Method Versus Specialty Bed: A Retrospective Comparison Cohort Study.

The purpose of this study was to compare the incidence of hospital-acquired pressure injuries (HAPIs) in patients with acute respiratory distress syndrome (ARDS) and placed in a prone position manually or using a specialty bed designed to facilitate prone positioning. A secondary aim was to compare mortality rates between these groups. Retrospective review of electronic medical records. The sample comprised 160 patients with ARDS managed by prone positioning. Their mean age was 61.08 years (SD = 12.73); 58% (n = 96) were male. The study setting was a 355-bed community hospital in the Western United States (Stockton, California). Data were collected from July 2019 to January 2021. Data from electronic medical records were retrospectively searched for the development of pressure injuries, mortality, hospital length of stay, oxygenation status when placed in a prone position, and the presence of a COVID-19 infection. A majority of patients with ARDS were manually placed in a prone position (n = 106; 64.2%), and 54 of these patients (50.1%) were placed using a specialty care bed. Slightly more than half (n = 81; 50.1%) developed HAPIs. Chi-square analyses showed no association with the incidence of HAPIs using manual prone positioning versus the specialty bed (P = .9567). Analysis found no difference in HAPI occurrences between those with COVID-19 and patients without a coronavirus infection (P = .8462). Deep-tissue pressure injuries were the most common type of pressure injury. More patients (n = 85; 80.19%) who were manually placed in a prone position died compared to 58.18% of patients (n = 32) positioned using the specialty bed (P = .003). No differences in HAPI rates were found when placing patients manually in a prone position versus positioning using a specialty bed designed for this purpose.

The S-Web Origin of Composition Enhancement in the Slow-to-moderate Speed Solar Wind

Connecting the solar wind observed throughout the heliosphere to its origins in the solar corona is one of the central aims of heliophysics. The variability in the magnetic field, bulk plasma, and heavy ion composition properties of the slow wind are thought to result from magnetic reconnection processes in the solar corona. We identify regions of enhanced variability and composition in the solar wind from 2003 April 15 to May 13 (Carrington Rotation 2002), observed by the Wind and Advanced Composition Explorer spacecraft, and demonstrate their relationship to the separatrix–web (hereafter, S-Web) structures describing the corona’s large-scale magnetic topology. There are four pseudostreamer (PS) wind intervals and two helmet streamer (HS) heliospheric current sheet/plasma sheet crossings (and an interplanetary coronal mass ejection), which all exhibit enhanced alpha-to-proton ratios and/or elevated ionic charge states of carbon, oxygen, and iron. We apply the magnetic helicity–partial variance of increments (H m –PVI) procedure to identify coherent magnetic structures and quantify their properties during each interval. The mean duration of these structures are ∼1 hr in both the HS and PS wind. We find a modest enhancement above the power-law fit to the PVI waiting-time distribution in the HS-associated wind at the 1.5–2 hr timescales that is absent from the PS intervals. We discuss our results in the context of previous observations of the ∼90 minutes periodic density structures in the slow solar wind, further development of the dynamic S-Web model, and future Parker Solar Probe and Solar Orbiter joint observational campaigns.

ATOMIC OXYGEN IN LOW EARTH ORBITS, A RETROSPECTIVE REVIEW STUDY

The article presents a retrospective review of atomic oxygen (AO) research in low Earth orbit (LEO).The space environment of LEO is a barrier to all satellites passing through it. Several of its constituent parts pose a great danger to satellite materials and subsystems. Such orbits are convenient for remote sensing and experimental satellites. In order to maintain the operational level of spacecraft, it is necessary to carry out thorough studies of the LEO environment and its components. AO, which is a hyperactive state of oxygen, is considered one of the most dangerous components of the LEO environment. It can react with many materials and thereby change the physical, optical and mechanical properties that affect the functionality of the satellite. To maintain the satellite in its orbit with a certain margin of reliability, it is necessary to reduce the aggressive influence on it of the environmental components of LEO. Predicting the impact of AO on materials that will be used in space ensures their correct selection. The work provides some recommendations for the creation of AO facilities for testing materials exposed to the aggressive influence of the space environment.

Unraveling the atomic and electronic structure of nanocrystals on superconducting Nb(110): Impact of the oxygen monolayer

The niobium surface is almost always covered by a native oxide layer which greatly influences the performance of superconducting devices. Here we investigate the highly stable niobium oxide overlayer of Nb(110), which is characterized by its distinctive nanocrystal structure as observed by scanning tunneling microscopy (STM). Our ab initio density functional theory (DFT) calculations show that a subtle reconstruction in the surface niobium atoms gives rise to rows of fourfold coordinated oxygen separated by regions of threefold coordinated oxygen. The fourfold oxygen rows are determined to be the source of the nanocrystal pattern observed in STM and the two chemical states of oxygen observed in core-level x-ray photoelectron spectroscopy (XPS) are ascribed to the threefold and fourfold oxygens. Furthermore, we find excellent agreement between the DFT calculated electronic structure with scanning tunneling spectroscopy and valence XPS measurements.

Effects of redox variability and early diagenesis on marine sedimentary Hg records

Volcanism is a dominant natural source of mercury (Hg) to the atmosphere, biosphere, ocean and sediments. In recent years, sedimentary Hg contents have emerged as a tool to reconstruct volcanic activity, and particularly activity of (subaerially emplaced) large igneous provinces in geological deep time. More specifically, Hg has shown potential as a useful proxy to illuminate the previously elusive impact of such large-scale volcanism on marine and terrestrial paleo-environments. While Hg is now widely applied as volcanism tracer, non-volcanic factors controlling sedimentary Hg content are generally not well constrained. Part of this uncertainty stems from our inability to directly observe a natural unperturbed “steady-state” environment as a baseline, as the modern Hg cycle is heavily influenced by anthropogenic activity. Here we focus on the effects of ambient redox conditions in the water column and shallow sediments (early diagenesis), quantify their influence on the geological Hg record and thereby contribute to constraining their potential impact on the use of Hg as a proxy for deep-time volcanic activity. Constraining these factors is of critical importance for the application of Hg as such a proxy. Many periods in the geological past for which records have been generated, such as the Mesozoic Oceanic Anoxic Events, are marked by a variety of high-amplitude environmental perturbations, including widespread deoxygenation and deposition of organic-rich sediments. We estimate the impact of redox changes and early diagenesis on the geological Hg record using a suite of (sub)recent–Pleistocene and Upper Cretaceous sediments representing oxic to euxinic marine conditions. Our sample set includes a transect through an oxygen minimum zone and cores that record transient shifts in oxygenation state, as well as post-depositional effects – all unrelated to volcanism, to the best of our knowledge. We find substantial alterations to the Hg record and the total organic carbon and total sulfur content, which are typically assumed to be the most common carrier phases of Hg in marine sediments. Moreover, these biases can lead to signal alteration on a par with those interpreted to result from volcanic activity. Geochemical modifications are ubiquitous and their potential magnitude implies that the factors leading to biases in the geological record warrant careful consideration before interpretation. Factors of particular concern to proxy application are (1) the disproportionate loss of organic carbon and sulfur relative to Hg during oxidation that strongly modulates normalized Hg records, (2) the evasion of Hg in anoxic and mildly euxinic sediments and (3) sharp focusing of Hg during post-depositional oxidation of organic matter. We suggest that paired analyses of additional redox-sensitive trace elements such as molybdenum, and organic-matter characteristics, particularly the type of organic matter, could provide first-order constraints on the role that redox and diagenetic changes played in shaping the Hg record as part of checking the attribution of enrichments to volcanic activity.

Evaluating the Effectiveness of Intravenous Ozonated Normal Saline in the Treatment of Severe COVID-19 Disease: A randomized control trial

Background: There is still no specific treatment strategy for COVID-19 other than supportive management. The potential biological benefits of ozone therapy include reduced tissue hypoxia, decreased hypercoagulability, modulated immune function by inhibiting inflammatory mediators, improved phagocytic function, and impaired viral replication. This study aimed to evaluate the effect of intravenous ozonated normal saline on patients with severe COVID-19 disease. Methods: In this study, a single centralized randomized clinical trial was conducted on 80 hospitalized patients with severe COVID-19. The patients were selected by random allocation method and divided into two groups A and B. In group A (control group), patients were given standard drug treatment, and in group B (intervention group), patients received ozonated normal saline in addition to the standard drug treatment. In the intervention group, 400 mL of normal saline was weighed by 40 μg/ kg of body weight and was injected into patients within 15 to 30 minutes (80 to 120 drops per minute). This process was done daily every morning for a week. Primary and secondary outcomes of the disease included changes in the following items: length of hospital stay, inflammatory markers including C-reactive protein (CRP), clinical recovery, arterial blood oxygen status, improvement of blood disorders such as leukopenia and leukocytosis, duration of ventilator attachment, and rapid clearance of lung lesions on CT scans. The need for intensive care unit (ICU) hospitalization, the length of ICU stay, and the mortality rate in patients of the two groups was compared. Results: According to the results of the initial outcome variable analysis, the probability of discharge of patients who received the normal ozonated saline intervention was 33% higher than patients who did not receive this intervention; however, this relationship was not statistically significant (HR=0.67, 95%, CI=0.42-1.06, P value=0.089). The chance of ICU hospitalization in patients of the intervention group was three times more than that of the comparison group, but this relationship was not significant (odds ratio=4.4 95% CI=1.32-14.50, P value=0.016). The use of ozonated normal saline was found to increase the risk of death by 1.5 times but this relationship was not statistically significant (odds ratio=1.5, 95% CI=.24-9.75, P value=0.646). Ozonated normal saline had a significant effect on changes in respiration rate (in the intervention group the number of breaths was decreased) and the erythrocyte sedimentation rate (in the intervention group the erythrocyte sedimentation rate was increased); however, it had no significant effect on other indicators. Conclusion: The present study showed that ozone therapy in hospitalized patients with severe COVID-19 could help improve some primary and secondary outcomes of the disease. Governments and health policymakers should make ozone therapy an available care service so that the need for advanced treatment facilities decreases; consequently, this measure may improve patient safety, prevent lung tissue destruction, and control cytokine storms in patients. Additionally, health decision-makers need to aim for the effective clinical improvement of patients, especially severe ones, and the reduction of their mortality. However, further large-scale multicenter studies with larger sample sizes considering drug side effects and other variables influencing the clinical course of COVID-19 can provide more information on the effectiveness and importance of ozone therapy.

De-clustered nonbonding oxygen state inhibits oxygen dimerization for highly activated and stable anionic redox in sodium-based layered cathodes

Manganese-based layered transition metal (TM) oxides with anionic redox reaction (ARR) activity hold great promise for low-cost and high-energy–density sodium-ion batteries cathodes. However, the unstable ARR charge compensation readily causes cycled capacity loss and voltage decay which severely restrict these materials’ commercial applications. Here, we show that a de-clustered distribution of nonbonding oxygen 2p state can enhance the stability of ARR and meanwhile increase its activity. The de-clustered nonbonding oxygen 2p state is achieved through regulating the ordered degree of cationic distributions that is superstructure in the TM layer. The designed cathode with relatively intact superstructure shows a record ARR activity and significantly suppressed voltage decay (0.52 mV per cycle). In-situ Raman indicates that the de-clustered nonbonding oxygen 2p state leads to an inhibited oxygen dimerization which is critical for stabilizing the ARR. Through employing in-situ X-ray diffraction, we reveal that the eliminated O–O dimers suppresses detrimental P2-P2′ phase transitions, leading to an ultralow volume change of 0.24% upon cycling. The robust Na-de/intercalation structure accompanying ARR process is further supported by theoretical calculations.

Resilient amphipods: Gammarid predatory behaviour is unaffected by microplastic exposure and deoxygenation

Microplastics are a ubiquitous and persistent form of pollution globally, with impacts cascading from the cellular to ecosystem level. However, there is a paucity in understanding interactions between microplastic pollution with other environmental stressors, and how these could affect ecological functions and services. Freshwater ecosystems are subject to microplastic input from anthropogenic activities (eg. wastewater), but are also simultaneously exposed to many other stressors, particularly reduced dissolved oxygen availability associated with climatic warming and pollutants, as well as biological invasions. Here, we employ the comparative functional response method (CFR; quantifying and comparing organism resource use as a function of resource density) to investigate the relative impact of different microplastic concentrations and oxygen regimes on predatory trophic interactions of a native and an invasive alien gammarid (Gammarus duebeni and Gammarus pulex). No significant effect on trophic interaction strengths was found from very high concentrations of microplastics (200 mp/L and 200,000 mp/L) or low oxygen (40 %) stressors on either species. Additionally, both gammarid species exhibited significant Type II functional responses, with attack rates and handling times not significantly affected by microplastics, oxygen or gammarid invasion status. Thus, both species showed resistance to the simultaneous effects of microplastics and deoxygenation in terms of feeding behaviour. Based on these findings, we suggest that the trophic function, in terms of predation rate, of Gammarus spp. may be sustained under acute bouts of microplastic pollution even in poorly‑oxygenated waters. This is the first study to investigate microplastic and deoxygenation interactions and to find no evidence for an interaction on a key invertebrate ecosystem service. We argue that our CFR methods can help understand and predict the future ecological ramifications of microplastics and other stressors across taxa and habitats.

Modulating influence of wistar rats’ oxygen status on behavioural manifestations of nitrogen narcosis: experimental study

OBJECTIVE of the study is to determine the influence of changing oxygen status in the animal’s body on nitrogen toxic effect under pressure. MATERIALS AND METHODS: A hyperbaric chamber was used to create normothermic effect of hyperbaric nitrogen up to 4,1 MPa amid changing oxygen concentration from 0,03 to 0,004 MPa, recording rats’ motor activity and posture reflexes. RESULTS: Oxygen decrease in the respiratory gas medium from 0,021 to 0,004 MPa due to nitrogen compression raised biphasic sensitivity of Wistar rates to nitrogen toxic effect. Yet in the sites of non-compensable hypoxia sensitivity to hyperbaric nitrogen effect increased 4,5 times. Preliminary exposure of pregnant rats in hypoxia led to decrease in the offspring’s sensitivity to toxic effect of hyperbaric nitrogen by 35% on average after reaching puberty. DISCUSSION: The obtained data allows to regard toxic effect of hyperbaric nitrogen as oxygen-dependent process. While hypoxia along with hyperbaric nitrogen effect enhances nitrogen narcosis, hypoxia, prior to nitrogen compression, reduces intoxication of this gas.

Application of optical analysis methods for non-invasive monitoring of blood oxygen saturation level

An intelligent optical system for medical express diagnostics has been developed and tested. A method for visualizing the oxygen status of biological tissues in the form of "digital images" describing the general functional state of the human body is demonstrated. It has been shown that the method of principal components and hierarchical clustering can be used in combination with optical methods for detecting hemoglobin forms in biological tissues to perform non-invasive monitoring and express diagnostics of the oxygen status of the human body. The results obtained show that it is possible to stratify the subjects into risk groups based on optical sensor readings. In comparison with pulse oximetry, the use of which is common for determining the oxygen saturation level of blood, the described method can be employed to estimate peripheral oxygen saturation, and thus thrombosis and ischemia of the extremities can be detected in time.

Efficient production of singlet oxygen and organic triplet excited states in aqueous PM2.5 in Hong Kong, South China

Efficient production of singlet oxygen and organic triplet excited states in aqueous PM2.5 in Hong Kong, South China

Effectiveness of lumacaftor/ivacaftor in 1-year therapy of cystic fibrosis in adult patients

Introduction. Cystic fibrosis is a severe systemic multiorgan exocrinopathy, the severity of the condition in 95% cases is caused by the depth of respiratory organ damage. Symptom management drugs that were developed over more than 50 years allowed to improve survival, but average life expectancy in cystic fibrosis (CF) remains well below the general population average. Targeted therapy is the most promising treatment, which restores the chloride channel function. Lumacaftor/ivacaftor is the first targeted therapy drug authorized in Russia.Aim. To evaluate the effect of lumacaftor/ivacaftor therapy on the respiratory function, microbiological profile, nutritional and oxygen status, as well as the rescue antibiotic therapy coverage in adult patients with CF.Materials and methods. 39 adult patients with CF received lumacaftor/ivacaftor for one year. The therapy effectiveness endpoints included the changes in indices of the pulmonary function tests: FEV1, FVC, FEV1/FVC, sweat test results, nutritional and oxygen status, antibiotic therapy coverage. The tolerability of the drug was assessed. The median age of patients was 28.9 (11.3) years. 6 patients (15.4%) discontinued therapy due to different adverse reactions.Results. The median increase in FVC was 2.9 (4.1)%, in FEV1 – 3.1 (4.1)%, sweat chloride decreased by 21 (27) mmol/l during 1–1.5-month lumacaftor/ivacaftor therapy. After 12-month therapy, the median increase in FVC was 2.3 (3.6)%, in FEV1 – 2.4 (3.8)%, BMI increased by 0.6 (0.6) kg/m2 and the frequency of rescue antibiotic therapy decreased by half. The patients showed a significant increase in FVC and FEV1 indices and a decrease in sweat chloride after 1-month therapy and an increase in FEV1 indices, BMI vales as well as a reduced need for rescue antibiotic therapy after 12-month therapy.Conclusion. The first experience with a long-term pathogenetic therapy with lumacaftor/ivacaftor in adult patients with CF in Russia demonstrated the expected positive effect on the respiratory function and changes in nutritional status, a reduced need for rescue antibiotic therapy, and low rates of adverse reactions.

Metabolic regulation of quiescence in plants.

Quiescence is a crucial survival attribute in which cell division is repressed in a reversible manner. Although quiescence has long been viewed as an inactive state, recent studies have shown that it is an actively monitored process that is influenced by environmental stimuli. Here, we provide a perspective of the quiescent state and discuss how this process is tuned by energy, nutrient and oxygen status, and the pathways that sense and transmit these signals. We not only highlight the governance of canonical regulators and signalling mechanisms that respond to changes in nutrient and energy status, but also consider the central significance of mitochondrial functions and cues as key regulators of nuclear gene expression. Furthermore, we discuss how reactive oxygen species and the associated redox processes, which are intrinsically linked to energy carbohydrate metabolism, also play a key role in the orchestration of quiescence.

Asuhan Keperawatan Ketidakefektifan Pola Nafas dengan Asma Bronkial di Ruang Lavender RSUD dr. R Goeteng Taroenadibrata Purbalingga

Introduction: Bronchial asthma is a chronic inflammatory disorder in the respiratory tract that attacks the trachea and bronchi which are commonly found among the public. Factors that can trigger bronchial asthma attacks include allergy, gender, genetic or hereditary factors, respiratory tract infections, excessive exercise, cigarette smoke irritants, weather changes, and environmental factors. Narrowing of the airway can cause wheezing, coughing, or shortness of breath. Recurrence of asthma can cause the sufferer to have difficulty breathing so that the incoming air is reduced. Objectives: The purpose of this case study is to describe the nursing care ineffectiveness of breath patterns in Mr. A with bronchial asthma Method: Researchers use the case study method with the stages of the nursing process including assessment, formulation of nursing diagnoses, planning, implementation, evaluation and documentation. Nursing care is given for 3 days using nebulizer therapy. Data collection is carried out by interview, observation, and documentation methods Result: The results were obtained by patients complaining of shortness of breath for 4 days and having a history of asthma. Physical examination obtained blood pressure 160/80 mmHg, temperature 36.3°C, pulse 89 x/min, SpO2 88%, RR 30 x/min, shallow breathing and additional breathing sounds ( wheezing) Conclusion: The author performs airway nursing care for 3x24 hours with breathing monitors, teaches deep breathing techniques, positions patients semi-fowler or as comfortably as possible, monitors oxygen status, monitors vital signs and the administration of collaborative therapy administering bronchodilator nebulizers. The patient's problem is solved by the intervention.

Relevance of serum levels of the endoplasmic reticulum stress protein GRP78 (glucose-regulated protein 78 kDa) as biomarker in pulmonary diseases

Cellular stress and inflammation contribute to the initiation and progression of a variety of pulmonary diseases. Endoplasmic reticulum (ER) stress and its main regulator GRP78 (glucose-regulated protein 78 kDa) appear to be involved in the pathogenesis of pulmonary diseases, and GRP78 was found to be a biomarker in a wide range of inflammatory diseases. The aim of this study was to investigate the relevance of serum GRP78 in pulmonary disorders.In this prospective cohort study, 78 consecutive patients with chronic obstructive pulmonary disease (COPD, n = 28), asthma (n = 38) or interstitial lung disease (ILD, n = 12) underwent measurement of serum GRP78 levels by ELISA.The mean age of patients was 59.8 ± 12.4 years, 48.7% were female. Patients with elevated GRP78 levels (> median) offered a significantly better oxygenation status (capillary pO2: 75.3 ± 11.7 mmHg vs. 67.8 ± 15.9 mmHg, p = 0.02). Significant correlations were observed between GRP78, on the one hand, and haemoglobin, high-sensitivity C-reactive protein (hs-CRP) and eosinophil counts, on the other hand (haemoglobin: Pearson’s r = −0.25, hs-CRP: r = 0.30, eosinophils: r = 0.63).Subsequently, we evaluated GRP78 measurements in function of severity stratifiers of the specific underlying pulmonary disease. ILD patients with a severe diffusion impairment (DLCO< 40% of predicted), exhibited a significant decrease in GRP78 levels (p = 0.01). In COPD and asthma, both characterized by obstructive ventilatory defects, a forced expiratory volume in one second (FEV1) <30% of predicted was accompanied by significantly lower GRP78 (p = 0.0075).In both obstructive and restrictive pulmonary disorders, GRP78 protein concentrations were reduced with increasing disease severity. These data suggest a prevalent role of GRP78 in the presently studied pulmonary disorders.

Abstract 2994: Hypoxia blocks the presentation of tumor antigens to CD8+ T cells

Abstract Tumor hypoxia is known to enhance tumor growth and immune evasion by activating angiogenic pathways supporting tumor progression and fostering suppressive phenotypes of immune cells within the tumor-microenvironment. However, the consequence of tumor hypoxia on antigen processing and presentation to surveilling CD8+ T cells is a notable knowledge gap with direct relevance towards adaptive immune responses against cancer. Here, we present evidence using the well-established OT-I transgenic model that hypoxia decreases antigen specific T cell effector responses, and importantly, that these decreases in effector responses are not attributable to any hypoxic influence on T cell function. Murine B16 melanoma cells expressing ovalbumin (OVA; MO4) or parental B16 were grown under 20% or 2% oxygen for 48 hours. These cells were then treated with 0 or 10 ng/mL recombinant murine interferon gamma (IFN-g) for 24 hours at their respective oxygen conditions. For analysis of cytotoxicity and effector responses, these cells were labeled with a fluorescence enhancing ligand (BATDA) and then incubated with OT-I T cells recognizing OVA-peptide (SIINFEKL) presented by C57BL/6 mouse MHC I (H2kb) for 4 hours at 20% oxygen. Supernatants were then tested for BATDA release using a europium solution and subsequent fluorescent signal acquisition. OT-I T cells displayed significantly more specific lysis of target MO4 cells cultured under 20% oxygen compared to those cultured under 2% oxygen (p value &amp;lt; 0.0001; 2-way ANOVA). Control experiments using parental B16 target cells displayed little to no specific lysis. Additionally, OT-I T cells were incubated with B16 or MO4 cells cultured as described above for 18 hours under 20% oxygen in the presence of protein transport inhibitors and analyzed for effector cytokine production. Tumor necrosis factor alpha (TNF-a) production was significantly increased in OT-I cells co-cultured with IFN-g treated MO4 target cells preconditioned in both 20% and 2% oxygen (p value &amp;lt; 0.05; unpaired T test), however the fold change in TNF-a production for OT-I cells incubated with 20% oxygen cultured MO4 cells was approximately twice the increase observed in OT-I cells incubated with 2% oxygen cultured MO4 cells. These differences are not attributable to altered OVA expression under hypoxia. Furthermore, IFN-g dependent up-regulation of MHC-I and immunoproteasome catalytic subunits was found to be blocked by hypoxia, suggesting that hypoxic attenuation of the MHC I pathway is responsible for observed decreases in cytotoxic and effector responses in OT-I co-culture assays. Overall, these studies suggest that tumor hypoxia blunts anti-tumor immune responses irrespective of the oxygenation status of surveilling CD8+ T cells. Citation Format: Matthew G. Smith, Heena Panchal, Adam Mailloux. Hypoxia blocks the presentation of tumor antigens to CD8+ T cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2994.

Validation of the Pediatric Resuscitation and Trauma Outcome (PRESTO) model in injury patients in Tanzania

IntroductionSub-Saharan Africa has the highest rate of unintentional paediatric injury deaths. The Pediatric Resuscitation and Trauma Outcome (PRESTO) model predicts mortality using patient variables available in low-resource settings: age, systolic...

Effectiveness of Prone Positioning versus Supine Positioning in Patients Suffering from Refractory ARDS: A Meta-Analysis

Prone positioning (PP) was advocated more than 40 years ago as a means of improving the oxygenation status in patients exhibiting acute respiratory failure (ARF) and acute respiratory distress syndrome (ARDS).

Aerobic capacity and [Formula: see text] kinetics adaptive responses to short-term high-intensity interval training and detraining in untrained females.

This study investigated the physical fitness and oxygen uptake kinetics (τ[Formula: see text]) along with the O2 delivery and utilization (heart rate kinetics, τHR; deoxyhemoglobin/[Formula: see text] ratio, ∆[HHb]/[Formula: see text]) adaptations of untrained female participants responding to 4weeks of high-intensity interval training (HIIT) and 2weeks of detraining. Participants were randomly assigned to HIIT (n = 11, 4 × 4 protocol) or nonexercising control (n = 9) groups. Exercising group engaged 4weeks of treadmill HIIT followed by 2weeks of detraining while maintaining daily activity level. Ramp-incremental (RI) tests and step-transitions to moderate-intensity exercise were performed. Aerobic capacity and performance (maximal oxygen uptake, [Formula: see text]; gas-exchange threshold, GET; power output, PO), body composition (skeletal muscle mass, SMM; body fat percentage, BF%), muscle oxygenation status (∆[HHb]), [Formula: see text], and HR kinetics were assessed. HIIT elicited improvements in aerobic capacity ([Formula: see text], + 0.17 ± 0.04 L/min; GET, + 0.18 ± 0.05 L/min, P < 0.01; PO-[Formula: see text], ± 23.36 ± 8.37 W; PO-GET, + 17.18 ± 3.07 W, P < 0.05), body composition (SMM, + 0.92 ± 0.17kg; BF%, -3.08% ± 0.58%, P < 0.001), and speed up the τ[Formula: see text] (-8.04 ± 1.57s, P < 0.001) significantly, extending to better ∆[HHb]/[Formula: see text] ratio (1.18 ± 0.08 to 1.05 ± 0.14). After a period of detraining, the adaptation in body composition and aerobic capacity, as well as the accelerated τ[Formula: see text] were maintained in the HIIT group, but the PO-[Formula: see text] and PO-GET declined below the post-training level (P < 0.05), whereas no changes were reported in controls (P > 0.05). Four weeks of HIIT induced widespread physiological adaptations in females, and the majority of improvements were preserved after 2 weeks of detraining except for power output corresponding to [Formula: see text] and GET.

Effect of high-flow nasal cannula on patients' recovery after inhalation general anesthesia.

To investigate the effect of high-flow nasal cannula (HFNC) and Oxygen Nebuliser mask (ONM) on patients recovering from inhalation anesthesia. A retrospective analysis was performed on 128 patients after inhalation of general anesthesia in the recovery room of the Anesthesiology Department of The Fourth Hospital of Hebei Medical University from September 2019 to September 2021. All patients received the same anesthesia induction and analgesia methods, inhalation anesthesia or intravenous-inhalation anesthesia maintenance, recovered spontaneous breathing and removed endotracheal intubation after surgery, then were divided into HFNC group and ONM group for oxygen therapy. HFNC setting mode: flow rate: 20-60 L/minutes, humidification temperature: 37°C, the oxygen concentration was adjusted to maintain finger pulse oxygen saturation SPO2>90%; ONM group, the oxygen flow rate was adjusted to maintain finger pulse oxygen saturation SPO2>90%. All patients in the two groups were compared immediately after they entered the recovery room for 0 minutes,, 10 minutes, and 20 minutes,, including tidal volume, blood gas, Richmond Agitation-Sedation Scale (RASS) score and time from sedation to awakening. The changes in tidal volume, oxygenation index and RASS score over time in the HFNC group were higher than those in the ONM group (p<0.05), and the awakening time in the HFNC group was faster than that in the ONM group (p<0.01), with significant statistical differences. Compared with ONM, HFNC can shorten postoperative recovery time, reduce the incidence of agitation and improve lung function and oxygenation state during recovery from anesthesia.