Browse Articles

Glycemic Variability and Outcomes in Sepsis: There\'s No Smoke without Fire!

Correction: Polyhydroxyalkanoate production in Priestia megaterium strains from glycerol feedstock

Research on visual design of urban multimedia portal

Perme Score and Machine Learning for Detecting ICU-acquired Weakness: A Prospective Observational Cohort Study

Virtual reality as a strategy for intra-operatory anxiolysis and pharmacological sparing in patients undergoing breast surgeries: The V-RAPS randomized controlled trial protocol

Introduction Virtual reality (VR) has increasingly found applications beyond leisure and video games, extending into the field of medicine. Recent studies indicate that VR can effectively reduce anxiety and pain in pediatric patients undergoing uncomfortable medical procedures, such as burn wound care. Yet, VR use in the operating room is still rare, despite a growing trend toward regional anesthesia without general anesthesia; physicians still frequently rely on pharmacological sedation to manage procedural anxiety. By leveraging VR’s anxiolytic properties, it may be possible to decrease the need for intravenous (IV) sedation which is associated with risk of adverse events like apnea and hypoxemia and delayed recovery. Objectives This study’s main objective is to determine the impact of VR on IV sedation requirements in adult patients undergoing breast surgery under paravertebral (PV) block without general anesthesia. We will be using Paperplane Therapeutics’ VR headset and software which offer three distinct VR scenario choices. We hypothesize that VR immersion will reduce the need for intraoperative pharmacological sedation. Secondary objectives include assessing the tolerance of patients to the VR headset, examining the impact of the chosen VR scenario on the primary outcome, evaluating the incidence of adverse effects, measuring patient satisfaction, and analyzing the output of the Nociception Level (NOL) Index among awake surgical patients. Materials and methods This single center randomized controlled trial will enroll 100 patients aged 18 or above undergoing breast surgery under PV block. Participants will be randomly allocated to the VR group or the control group; both will have access to pharmacological sedation through patient-controlled sedation (PCS). Participants in the VR group will choose between three different VR scenarios and will be allowed to switch between these scenarios during surgery. The primary outcome will be the time-adjusted and weight adjusted dose of self-administered intraoperative propofol. Secondary outcomes will include patient satisfaction, adverse events, and post-anesthesia care unit length of stay (PACU LOS). Ethics This trial has been approved by the regional ethics committee (Comité d’Éthique de la Recherche du CIUSSS de l’Est de l’Île de Montréal) on September 9 th , 2024. Trial registration ClinicalTrials.gov (July 25th, 2024). Unique protocol ID: 2025–3802. Trial identification number: NCT06522711.

A simulation study on risk emergence mechanism and transmission path of coal mine workers’ unsafe behaviours based on DEMATEL-ISM and Arena simulation

Author Response: Patients with Benzodiazepine Intoxication Require Neurological and Psychiatric Examination in Order to Guide and Monitor Withdrawal

Evaluating the effectiveness of integrating biofeedback in the treatment of aggressive outbursts (BRET-IA2): A study protocol

Introduction: This study provides a comprehensive overview of the materials and methods used to evaluate the effectiveness of the use of biofeedback in the treatment of aggressive episodes in children and adolescents. Background: Aggressive episodes are common in various disorders and are associated with deficits in emotional processing and impulse control, primarily due to dysfunctions in the amygdala and prefrontal cortex (PFC). These brain regions also regulate physiological arousal, influencing heart rate and other autonomic functions even before aggression manifests. These early signals can be shown to the person (biofeedback) reinforcing therapeutic skills to enhance emotional regulation and reduce aggression. Methods: A total of 70 participants will be recruited for a randomized controlled trial (RCT). All participants will receive therapy, although only the intervention group will incorporate biofeedback. The experimental study will be split into three blocks: (1) Home Monitoring: Physiological signals will be recorded using a smartwatch, and aggressive episodes will be captured with a camera; (2) Laboratory Assessment: Participants will attend three sessions, where therapists will induce aggressive reactions, using the video clips recorded at home. Simultaneously, real-time physiological signals will be measured. These sessions will also include relaxation periods before and after the provoked outburst; (3) Therapeutic Intervention: Similar to the laboratory assessment block, therapists will induce aggressive responses in three sessions; however, in this block, participants will receive therapy. Additionally, participants who belong to the intervention group, will include biofeedack in the therapy. Biofeedback is focused on heart rate (HR), heart rate variability (HRV), and skin conductance level (SCL). The CACIA, the Stroop, and other pre- and post-experimental tests. will be used to assess the differences between the control and intervention groups. Discussion: Emotions play a fundamental role in decision-making, social interactions, and mental health. Emotional dysregulation often leads to aggression, irritability, and anxiety. Showing physiological responses to patients, such as heart rate variability and skin conductance, may improve emotional awareness and regulation. This study aims to verify the effectiveness of including biofeedback in such therapy.

A translational protocol optimizes the isolation of plasma-derived extracellular vesicle proteomics

Abstract In translational research and clinical routine, liquid biopsy is a promising tool to direct individually targeted treatments. Among the components of liquid biopsy, extracellular vesicles (EVs) carry manyfold molecular cargo and are increasingly being studied for biomarker identification. In order to identify potential confounding factors and determine optimal conditions when studying blood-derived EV proteins, the impact of pre-analytical variables needs to be assessed. Here we establish an EV enrichment for proteomic analysis workflow in a real-world clinical setting in which we evaluate variables from blood collection through protein preparation and storage for mass spectrometry (MS). We assess hemolysis, particle concentration and size, protein quantity, protein markers and comprehensive proteomic analysis using mass spectrometry to assess the influence of different pre-analytical variables like blood collection tubes, transportation of blood samples and delayed processing. Under these conditions, density gradient and size exclusion chromatography using Sepharose CL-4B show good EV enrichment. For MS, lysis with increased protease inhibitors shows high protein yields while TCA protein precipitation results in high numbers of identified proteins. In summary, we develop here an optimized protocol for the analysis of plasma EV-derived proteomics, evaluating pre-analytical variables relevant for implementation in a clinical setting.

Clinical Profile, Intensive Care Needs, and Outcome of Children with Adenoviral Pneumonia: A Retrospective Study from a Tertiary Care Hospital in North India

The role of individual recognition in shaping empathy and trust toward an agent

When individuals receive assistance, the principle of reciprocity is often triggered. In social contexts, whether the actors are humans or AI/robots (hereafter referred to as agents), multiple individuals may engage in the same task. However, differences in capabilities can lead to varying levels of performance. This study investigated whether individuals improve greater empathy and trust toward an agent that provides assistance during a collaborative task, even when multiple agents are involved. Specifically, we examined a scenario in which one agent completes the remaining portion of a shared typing task under time constraints, acting on behalf of the others. To assess whether participants could distinguish between agents, we manipulated visual identity using color-coded agents. Data collected from 392 participants indicated that while people did not strongly differentiate between individual agents based on visual cues alone, supportive behavior by a single agent significantly enhanced trust and empathy. Interestingly, these positive impressions extended to visually similar, non-helping agents. These findings suggest that the presence of a helpful agent can promote broader acceptance and positive evaluation of agents in general, which may be beneficial for integrating agents into increasingly agent-assisted societies.

Physicochemical properties and sensory attributes of nut-based milk coffee

An Overview of Enterococcal Bacteremia with Potential Therapeutic Options

Circadian rhythm genes and immune cell infiltration in myasthenia gravis: A comprehensive analysis

The fluctuating weakness in myasthenia gravis (MG) is clinically described as the “morning improvement and evening worsening” pattern; MG is commonly associated with sleep disorders. However, there remains a paucity of research investigating the relationship between MG and circadian rhythms. This study seeks to identify pivotal circadian rhythm genes (CRGs) and characterize immune cell infiltration in MG, while exploring their potential roles in MG pathogenesis. MG data were obtained from the Gene Expression Omnibus (GEO) database. Initially, differentially expressed circadian rhythm genes between MG and control samples were identified through differential expression analysis. Subsequently, to elucidate the functional roles of differentially expressed CRGs, we conducted Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses. Finally, weighted gene co-expression network analysis (WGCNA) and least absolute shrinkage and selection operator (LASSO) regression were applied to identify the hub CRGs. The diagnostic utility of hub genes was evaluated using the receiver operating characteristic curve, and their protein expression levels in the serum of patients with MG were assessed utilizing enzyme-linked immunosorbent assay. Additionally, we examined the extent of immune cell infiltration in MG and explored its relationship with the identified hub genes. We analyzed the immune infiltration profile in MG and their correlation with the identified hub genes. The GO enrichment analysis revealed significant enrichment of differentially expressed genes in circadian rhythm-related biological processes. Our investigation identified two hub CRGs that exhibit high diagnostic specificity and sensitivity and are significantly upregulated in serum samples from MG patients. Furthermore, Immune cells were correlated with hub genes. Our findings suggest a potential circadian rhythm disorder in MG, which may offer novel biomarkers and therapeutic strategies for future research.

Physical self-perception as mediator between physical activity and quality of life among Chinese university students

Validation of Global Definition of Acute Respiratory Distress Syndrome in COVID-19 Patients: A Retrospective Study

pET28g: A Golden Gate-compatible pET vector for protein expression in Escherichia coli, validated by production of functional human ACE2

The pET28g plasmid is a new tool for protein expression in Escherichia coli. It was derived from pET28a by replacing the traditional multiple cloning site with a Golden Gate cassette containing the lacZα reporter gene. The assembly of pET28g is based on Golden Gate cloning, and it was designed as an extension of the MoClo Toolkit (Addgene Kit #1000000044). The pET28g plasmid, along with the level 0 modules developed in this work, expands the existing pET plasmid collection and offers a versatile and modular system for protein expression. These tools facilitate the establishment of efficient pipelines for the preparation and testing of multiple constructs, enabling the optimization of conditions to achieve high levels of soluble protein expression. As proof of concept, we successfully produced and purified the peptidase domain of human ACE2 using the pET28g system. Notably, this represents the first report of the successful purification of a functional human ACE2 protein from the Escherichia coli soluble protein fraction. This lab protocol, which is complemented by the protocol at www.protocols.io (https://www.protocols.io/view/preparation-of-level-0-modules-for-golden-gate-ass-j8nlk9e75v5r/v1), provides a comprehensive guide to understanding the nomenclature of the pET28g system and includes step-by-step instructions for the preparation of level 0 modules and the assembly of the final plasmid to express constructs of interest using pET28g.

Sleep disturbance and hypertension mediated by systemic inflammatory response index in NHANES

Letter on “Impact of Noninvasive Ventilation on Quality of Sleep among Patients Admitted to the Critical Care Unit” – Limitations and Recommendations

The relationship between confidence and gaze-at-nothing oculomotor dynamics during decision-making

How does confidence relate to oculomotor dynamics during decision-making? Do oculomotor dynamics reflect deliberation and the buildup of confidence in the absence of visual stimuli? Here we examine the hypothesis that working memory, deliberation, and confidence warp oculomotor dynamics, both in the presence and absence of visual stimuli. We analyzed oculomotor dynamics in a decision-making task in which participants were provided with an abstract context in which to make the decision, and two similar option images which became eventually invisible. We show that fixations between the empty locations in which the images were formerly shown continued after the options disappeared, consistently with a sustained deliberative process facilitated by oculomotor dynamics. Both, oculomotor dynamics and decision patterns remained unchanged regardless of whether the stimuli were visible. Furthermore, our analyses show that the number of alternating fixations between stimuli correlated negatively with the confidence reported after each decision, while the observation time of the selected target correlated positively. Given that decisions in our experimental paradigm are reported in the absence of the stimuli, this suggests a relationship between evidence retrieval from working memory, confidence gathering and oculomotor dynamics. Finally, we performed a model comparison based on predictions from drift-diffusion models to assess the relationship between sequential fixations between images, deliberation and confidence gathering, and the ensuing choice. These analyses supported confidence as a contributing cognitive process encompassing serial evidence-gathering and parallel option consideration during decision-making.