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Summary The aim of the present study was to determine the precision of the PiCCO® system for post-cardiac arrest patients who underwent therapeutic hypothermia. The precision of the measurements for cardiac output, global end-diastolic volume, extravascular lung water and the pulmonary vascular permeability index was assessed using the least significant change; this was regarded as precise when less than 15%. A total of 462 measurement sets were prospectively performed on 88 patients following successful resuscitation after cardiac arrest. Using the mean value of three injections for a measurement, the least significant change for the cardiac output, global end-diastolic volume, extravascular lung water and pulmonary vascular permeability index measurements were found to be 7.8%, 8.5%, 7.8% and 12.1%, respectively. No significant differences between hypothermia (n = 150) and non-hypothermia (n = 312) were found. The PiCCO-derived variables were found to be precise for post-cardiac arrest patients even under conditions of varying body temperature. [ABSTRACT FROM AUTHOR]

Leaves and stem segments of in vitro-cultured Calibrachoa excel/ens were used as explants to obtain transgenic hairy roots after inoculation with the following strains of Agrobacterium rhizogenes: LBA 15834, LBA 8490, LMG 155, and A13. Only leaves showed sensitivity towards Agrobacterium infection. A. rhizo genes strain LBA 15834 was the most virulent among the four strains tested, with 33% of leaves showing root and callus proliferation, while only 10% of the explants showed root and/or callus development using strain A13, and no responses were observed in explants infected with the other two strains used. Two different transformation events were recovered as transgenic plants regenerated from hairy roots via spontaneous organogenesis. These plants showed, to different degrees, the classic symptoms of hairy root disease. PCR analysis of the recovered plants showed the presence of the rol A, rol B, rol C, and rol D genes, and the absence of the vir D1 gene, confirming the absence of Agrobacterium. Southern blotting indicated the presence of one inserted copy in one transformation event, and two copies. in the other. Morphological and physiological differences were observed between the independent transformation events, as well as several differences such as flower colour and leaf shape, between plants of the same event. Pollen from one of the transformed plants was used to cross with commercial hybrids of Calibrachoa, and the presence of the rolA and rot B genes was confirmed in four out of 26 plants recovered that showed some hairy root characteristics. For the first time, transgenic hairy root- plants of the genus Calibrachoa have been regenerated, which would allow transgene incorporation into a breeding programme. [ABSTRACT FROM AUTHOR]

The title complex was a Mott insulator, in which the head-to-head type dimer of newly synthesized donor molecule, 2-(thiapyran-4-ylidene)-4,5-ethylenedioxy-1,3-dithiole (TP-EDOT) accommodated a localized spin. Although the localized spins were arranged in three-dimensional (3D) framework, the interaction between them was interpreted as a two-dimensional (2D) spin system. The ability of TP-EDOT to exhibit intermolecular interactions along the molecular longitudinal axis allowed to form a head-to-head dimer, which provided an elongated space to reserve a localized spin. The anisotropy of this dimer was regarded to be the origin of the novel 2D spin structure formed in the 3D lattice. [ABSTRACT FROM AUTHOR]

The authors investigated the magnetic anisotropy of epitaxial films of γ-Fe2O3(001) composed entirely of Fe3+. The cubic anisotropy term (K1) was negligibly small (K1≈-2.7×104 erg/cm3), as expected for L≈0 systems; however, substantially large uniaxial anisotropy energy (Ku≈6.1×105 erg/cm3) was found as the thickness reached the bulk limit. A detailed characterization of both the in-plane and out-of-plane lattice parameters revealed that the c/a ratio of the unit cell was intrinsically elongated due to its vacancy-ordered supercell. This unexpectedly large Ku is reasonably explained by simple dipole sums if the authors take into account the slightly stretched unit cell (c′/a=1.03) in the growth direction even without the spin-orbit interaction. [ABSTRACT FROM AUTHOR]

Background: Post-cardiac arrest syndrome (PCAS) presents a multifaceted challenge in clinical practice, characterized by severe neurological injury and high mortality rates despite advancements in management strategies. One of the important critical aspects of PCAS is post-arrest lung injury (PALI), which significantly contributes to poor outcomes. PALI arises from a complex interplay of pathophysiological mechanisms, including trauma from chest compressions, pulmonary ischemia-reperfusion (IR) injury, aspiration, and systemic inflammation. Despite its clinical significance, the pathophysiology of PALI remains incompletely understood, necessitating further investigation to optimize therapeutic approaches., Methods: This review comprehensively examines the existing literature to elucidate the epidemiology, pathophysiology, and therapeutic strategies for PALI. A comprehensive literature search was conducted to identify preclinical and clinical studies investigating PALI. Data from these studies were synthesized to provide a comprehensive overview of PALI and its management., Results: Epidemiological studies have highlighted the substantial prevalence of PALI in post-cardiac arrest patients, with up to 50% of survivors experiencing acute lung injury. Diagnostic imaging modalities, including chest X-rays, computed tomography, and lung ultrasound, play a crucial role in identifying PALI and assessing its severity. Pathophysiologically, PALI encompasses a spectrum of factors, including chest compression-related trauma, pulmonary IR injury, aspiration, and systemic inflammation, which collectively contribute to lung dysfunction and poor outcomes. Therapeutically, lung-protective ventilation strategies, such as low tidal volume ventilation and optimization of positive end-expiratory pressure, have emerged as cornerstone approaches in the management of PALI. Additionally, therapeutic hypothermia and emerging therapies targeting mitochondrial dysfunction hold promise in mitigating PALI-related morbidity and mortality., Conclusion: PALI represents a significant clinical challenge in post-cardiac arrest care, necessitating prompt diagnosis and targeted interventions to improve outcomes. Mitochondrial-related therapies are among the novel therapeutic strategies for PALI. Further clinical research is warranted to optimize PALI management and enhance post-cardiac arrest care paradigms., (© 2024. The Author(s).)

Background: Because of a scant report, it is little known that thyroid storms can occur after trauma, even in adolescence. Significantly, this increases the risk of delaying diagnosis resulting in life-threatening., Case Presentation: A 13-year-old girl was admitted to the emergency department after a traffic accident. Despite receiving comprehensive trauma care, the patient developed hyperthermia and tachycardia that did not respond to temperature management therapy. On the 10th day of her admission, she was diagnosed with a thyroid storm. Treatment for thyroid storm was initiated; thereby, her condition was totally improved., Conclusion: We experienced a case of an adolescent girl, who developed a thyroid storm during the treatment of trauma and could save her life. Clinicians should consider thyroid storm in post-traumatic hyperthermia and tachycardia patients, even in children., Competing Interests: The authors declare no conflicts of interest., (© 2024 The Author(s). Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine.)

Background: Mitochondrial dysfunction, which is triggered by systemic ischemia-reperfusion (IR) injury and affects various organs, is a key factor in the development of post-cardiac arrest syndrome (PCAS). Current research on PCAS primarily addresses generalized mitochondrial responses, resulting in a knowledge gap regarding organ-specific mitochondrial dynamics. This review focuses on the organ-specific mitochondrial responses to IR injury, particularly examining the brain, heart, and kidneys, to highlight potential therapeutic strategies targeting mitochondrial dysfunction to enhance outcomes post-IR injury., Methods and Results: We conducted a narrative review examining recent advancements in mitochondrial research related to IR injury. Mitochondrial responses to IR injury exhibit considerable variation across different organ systems, influenced by unique mitochondrial structures, bioenergetics, and antioxidative capacities. Each organ demonstrates distinct mitochondrial behaviors that have evolved to fulfill specific metabolic and functional needs. For example, cerebral mitochondria display dynamic responses that can be both protective and detrimental to neuronal activity and function during ischemic events. Cardiac mitochondria show vulnerability to IR-induced oxidative stress, while renal mitochondria exhibit a unique pattern of fission and fusion, closely linked to their susceptibility to acute kidney injury. This organ-specific heterogeneity in mitochondrial responses requires the development of tailored interventions. Progress in mitochondrial medicine, especially in the realms of genomics and metabolomics, is paving the way for innovative strategies to combat mitochondrial dysfunction. Emerging techniques such as mitochondrial transplantation hold the potential to revolutionize the management of IR injury in resuscitation science., Conclusions: The investigation into organ-specific mitochondrial responses to IR injury is pivotal in the realm of resuscitation research, particularly within the context of PCAS. This nuanced understanding holds the promise of revolutionizing PCAS management, addressing the unique mitochondrial dysfunctions observed in critical organs affected by IR injury.

The treehoppers (Hemiptera, Membracidae) are known for possessing a large three-dimensional structure called a helmet. Although some ecological functions of the helmet have already been elucidated, the developmental mechanisms underlying the complex and diverse morphology of the helmet are still largely unknown. The process of helmet formation was first described in Antianthe expansa , which possesses a simple roof-shaped helmet. However, the developmental process in species with more complex helmet morphologies remains largely unexplored. Hence, in this study, we used Poppea capricornis , which possesses a more complex helmet structure than A. expansa , to investigate the helmet development using paraffin sections, micro-CT, and scanning electronic microscopy. Our focus was on the overall helmet developmental process common to both species and formation of structures unique to Poppea and its comparison to Antianthe . As a result, we discovered that miniature structures were also formed in Poppea , similar to Antianthe , during the helmet formation. Common structures that were shared between the two species were discernible at this stage. Additionally, we observed that suprahumeral horns and posterior horns, two morphological traits specific to the Poppea helmet that are apparently similar anatomically, are formed through two distinctly different developmental mechanisms. The suprahumeral horns appeared to be formed by utilizing the nymphal suprahumeral bud as a mold, while we could not detect any nymphal structures potentially used for a mold in the posterior horns formation. Our findings suggest that the helmet formation mechanisms of Antianthe and Poppea employ a common mechanism but form species-specific structures by multiple mechanisms.

Introduction: Cardiac arrest is a critical condition, and patients often experience postcardiac arrest syndrome (PCAS) even after the return of spontaneous circulation (ROSC). Administering a restricted amount of oxygen in the early phase after ROSC has been suggested as a potential therapy for PCAS; however, the optimal target for arterial partial pressure of oxygen or peripheral oxygen saturation (SpO 2 ) to safely and effectively reduce oxygen remains unclear. Therefore, we aimed to validate the efficacy of restricted oxygen treatment with 94%-95% of the target SpO 2 during the initial 12 hours after ROSC for patients with PCAS., Methods and Analysis: ER-OXYTRAC (early restricted oxygen therapy after resuscitation from cardiac arrest) is a nationwide, multicentre, pragmatic, single-blind, stepped-wedge cluster randomised controlled trial targeting cases of non-traumatic cardiac arrest. This study includes adult patients with out-of-hospital or in-hospital cardiac arrest who achieved ROSC in 39 tertiary centres across Japan, with a target sample size of 1000. Patients whose circulation has returned before hospital arrival and those with cardiac arrest due to intracranial disease or intoxication are excluded. Study participants are assigned to either the restricted oxygen (titration of a fraction of inspired oxygen with 94%-95% of the target SpO 2 ) or the control (98%-100% of the target SpO 2 ) group based on cluster randomisation per institution. The trial intervention continues until 12 hours after ROSC. Other treatments for PCAS, including oxygen administration later than 12 hours, can be determined by the treating physicians. The primary outcome is favourable neurological function, defined as cerebral performance category 1-2 at 90 days after ROSC, to be compared using an intention-to-treat analysis., Ethics and Dissemination: This study has been approved by the Institutional Review Board at Keio University School of Medicine (approval number: 20211106). Written informed consent will be obtained from all participants or their legal representatives. Results will be disseminated via publications and presentations., Trial Registration Number: UMIN Clinical Trials Registry (UMIN000046914)., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)