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Purpose: An inspiratory muscle warm-up (IMW) improves inspiratory muscle function, but the effects of high-intensity exercise are inconsistent. We aimed to determine the effects of high-intensity IMW on high-intensity exercise performance and muscle oxygenation. Methods: Ten healthy men (maximal oxygen uptake [ V ˙ O 2 max ] 52.2 [5.0] mL·kg–1·min–1) performed constant-load exercise to exhaustion on a cycle ergometer at V ˙ O 2 max under 2 IMW conditions: a placebo condition (PLA) and a high-intensity IMW condition (HIGH). The inspiratory loads were set at 15% and 80% of maximal inspiratory pressure, respectively. Maximal inspiratory pressure was measured before and after IMW. Oxyhemoglobin was measured in the vastus lateralis by near-infrared spectroscopy during exercise. Rating of perceived exertion (RPE) for a leg was measured after 1 and 2 minutes of exercise. Results: Exercise tolerance was significantly higher under HIGH than PLA (228 [49] s vs 218 [49] s, P =.003). Maximal inspiratory pressure was significantly increased by IMW under HIGH (from 125 [20] to 136 [25] cm H2O, P =.031). Oxyhemoglobin was significantly higher under HIGH than PLA at 80% of the total duration of exercise (P =.048). RPE for the leg was significantly lower under HIGH than PLA after 2 minutes of exercise (P =.019). Conclusions: Given that oxyhemoglobin is an index of local oxygen supply, the results of this study suggest that high-intensity IMW increases the oxygen supply to active limbs. It may also reflect a reduction in RPE in the leg. In addition, high-intensity IMW may improve exercise performance. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To describe the utilization of early ketamine use among patients mechanically ventilated for COVID-19, and examine associations with in-hospital mortality and other clinical outcomes. DESIGN: Retrospective cohort study. SETTING: Six hundred ten hospitals contributing data to the Premier Healthcare Database between April 2020 and June 2021. PATIENTS: Adults with COVID-19 and greater than or equal to 2 consecutive days of mechanical ventilation within 5 days of hospitalization. INTERVENTION: The exposures were early ketamine use initiated within 2 days of intubation and continued for greater than 1 day. MEASUREMENTS: Primary was hospital mortality. Secondary outcomes included length of stay (LOS) in the hospital and ICUs, ventilator days, vasopressor days, renal replacement therapy (RRT), and total hospital cost. The propensity score matching analysis was used to adjust for confounders. MAIN RESULTS: Among 42,954 patients, 1,423 (3.3%) were exposed to early ketamine use. After propensity score matching including 1,390 patients in each group, recipients of ketamine infusions were associated with higher hospital mortality (52.5% vs. 45.9%, risk ratio: 1.14, [1.06-1.23]), longer median ICU stay (13 vs. 12 d, mean ratio [MR]: 1.15 [1.08-1.23]), and longer ventilator days (12 vs. 11 d, MR: 1.19 [1.12-1.27]). There were no associations for hospital LOS (17 [10-27] vs. 17 [9-28], MR: 1.05 [0.99-1.12]), vasopressor days (4 vs. 4, MR: 1.04 [0.95-1.14]), and RRT (22.9% vs. 21.7%, RR: 1.05 [0.92-1.21]). Total hospital cost was higher (median $72,481 vs. $65,584, MR: 1.11 [1.05-1.19]). CONCLUSIONS: In a diverse sample of U.S. hospitals, about one in 30 patients mechanically ventilated with COVID-19 received ketamine infusions. Early ketamine may have an association with higher hospital mortality, increased total cost, ICU stay, and ventilator days, but no associations for hospital LOS, vasopressor days, and RRT. However, confounding by the severity of illness might occur due to higher extracorporeal membrane oxygenation and RRT use in the ketamine group. Further randomized trials are needed to better understand the role of ketamine infusions in the management of critically ill patients.

BACKGROUND: Rapidly improving acute respiratory distress syndrome (RIARDS) is an increasingly appreciated subgroup of ARDS in which hypoxemia improves within 24 h after initiation of mechanical ventilation. Detailed clinical and biological features of RIARDS have not been clearly defined, and it is unknown whether RIARDS is associated with the hypoinflammatory or hyperinflammatory phenotype of ARDS. The purpose of this study was to define the clinical and biological features of RIARDS and its association with inflammatory subphenotypes. METHODS: We analyzed data from 215 patients who met Berlin criteria for ARDS (endotracheally intubated) and were enrolled in a prospective observational cohort conducted at two sites, one tertiary care center and one urban safety net hospital. RIARDS was defined according to previous studies as improvement of hypoxemia defined as (i) PaO2:FiO2 > 300 or (ii) SpO2: FiO2 > 315 on the day following diagnosis of ARDS (day 2) or (iii) unassisted breathing by day 2 and for the next 48 h (defined as absence of endotracheal intubation on day 2 through day 4). Plasma biomarkers were measured on samples collected on the day of study enrollment, and ARDS phenotypes were allocated as previously described. RESULTS: RIARDS accounted for 21% of all ARDS participants. Patients with RIARDS had better clinical outcomes compared to those with persistent ARDS, with lower hospital mortality (13% vs. 57%; p value

BACKGROUND: In healthy people, the fight-or-flight sympathetic system is counterbalanced by the rest-and-digest parasympathetic system. As we grow older, the parasympathetic system declines as the sympathetic system becomes hyperactive. In our prior heart rate variability biofeedback and emotion regulation (HRV-ER) clinical trial, we found that increasing parasympathetic activity through daily practice of slow-paced breathing significantly decreased plasma amyloid-β (Aβ) in healthy younger and older adults. In healthy adults, higher plasma Aβ is associated with greater risk of Alzheimers disease (AD). Our primary goal of this trial is to reproduce and extend our initial findings regarding effects of slow-paced breathing on Aβ. Our secondary objectives are to examine the effects of daily slow-paced breathing on brain structure and the rate of learning. METHODS: Adults aged 50-70 have been randomized to practice one of two breathing protocols twice daily for 9 weeks: (1) slow-paced breathing condition involving daily cognitive training followed by slow-paced breathing designed to maximize heart rate oscillations or (2) random-paced breathing condition involving daily cognitive training followed by random-paced breathing to avoid increasing heart rate oscillations. The primary outcomes are plasma Aβ40 and Aβ42 levels and plasma Aβ42/40 ratio. The secondary outcomes are brain perivascular space volume, hippocampal volume, and learning rates measured by cognitive training performance. Other pre-registered outcomes include plasma pTau-181/tTau ratio and urine Aβ42. Recruitment began in January 2023. Interventions are ongoing and will be completed by the end of 2023. DISCUSSION: Our HRV-ER trial was groundbreaking in demonstrating that a behavioral intervention can reduce plasma Aβ levels relative to a randomized control group. We aim to reproduce these findings while testing effects on brain clearance pathways and cognition. TRIAL REGISTRATION: ClinicalTrials.gov NCT05602220. Registered on January 12, 2023.

Fluid bolus therapy (FBT) is fundamental to the management of circulatory shock in critical care but balancing the benefits and toxicities of FBT has proven challenging in individual patients. Improved predictors of the hemodynamic response to a fluid bolus, commonly referred to as a fluid challenge, are needed to limit non-beneficial fluid administration and to enable automated clinical decision support and patient-specific precision critical care management. In this study we retrospectively analyzed data from 394 fluid boluses from 58 pigs subjected to either hemorrhagic or distributive shock. All animals had continuous blood pressure and cardiac output monitored throughout the study. Using this data, we developed a machine learning (ML) model to predict the hemodynamic response to a fluid challenge using only arterial blood pressure waveform data as the input. A Random Forest binary classifier referred to as the ML fluid responsiveness algorithm (MLFRA) was trained to detect fluid responsiveness (FR), defined as a ≥ 15% change in cardiac stroke volume after a fluid challenge. We then compared its performance to pulse pressure variation, a commonly used metric of FR. Model performance was assessed using the area under the receiver operating characteristic curve (AUROC), confusion matrix metrics, and calibration curves plotting predicted probabilities against observed outcomes. Across multiple train/test splits and feature selection methods designed to assess performance in the setting of small sample size conditions typical of large animal experiments, the MLFRA achieved an average AUROC, recall (sensitivity), specificity, and precision of 0.82, 0.86, 0.62. and 0.76, respectively. In the same datasets, pulse pressure variation had an AUROC, recall, specificity, and precision of 0.73, 0.91, 0.49, and 0.71, respectively. The MLFRA was generally well-calibrated across its range of predicted probabilities and appeared to perform equally well across physiologic conditions. These results suggest that ML, using only inputs from arterial blood pressure monitoring, may substantially improve the accuracy of predicting FR compared to the use of pulse pressure variation. If generalizable, these methods may enable more effective, automated precision management of critically ill patients with circulatory shock.

Mitochondrial membrane potential directly powers many critical functions of mitochondria, including ATP production, mitochondrial protein import, and metabolite transport. Its loss is a cardinal feature of aging and mitochondrial diseases, and cells closely monitor membrane potential as an indicator of mitochondrial health. Given its central importance, it is logical that cells would modulate mitochondrial membrane potential in response to demand and environmental cues, but there has been little exploration of this question. We report that loss of the Sit4 protein phosphatase in yeast increases mitochondrial membrane potential, both by inducing the electron transport chain and the phosphate starvation response. Indeed, a similarly elevated mitochondrial membrane potential is also elicited simply by phosphate starvation or by abrogation of the Pho85-dependent phosphate sensing pathway. This enhanced membrane potential is primarily driven by an unexpected activity of the ADP/ATP carrier. We also demonstrate that this connection between phosphate limitation and enhancement of mitochondrial membrane potential is observed in primary and immortalized mammalian cells as well as in Drosophila. These data suggest that mitochondrial membrane potential is subject to environmental stimuli and intracellular signaling regulation and raise the possibility for therapeutic enhancement of mitochondrial function even in defective mitochondria.

BackgroundNoninvasive respiratory support modalities are common alternatives to mechanical ventilation in acute hypoxemic respiratory failure. However, studies historically compare noninvasive respiratory support to conventional oxygen rather than mechanical ventilation. In this study, we compared outcomes in patients with acute hypoxemic respiratory failure treated initially with noninvasive respiratory support to patients treated initially with invasive mechanical ventilation.MethodsThis is a retrospective observational cohort study between January 1, 2018 and December 31, 2019 at a large healthcare network in the United States. We used a validated phenotyping algorithm to classify adult patients (≥18 years) with eligible International Classification of Diseases codes into two cohorts: those treated initially with noninvasive respiratory support or those treated invasive mechanical ventilation only. The primary outcome was time-to-in-hospital death analyzed using an inverse probability of treatment weighted Cox model adjusted for potential confounders. Secondary outcomes included time-to-hospital discharge alive. A secondary analysis was conducted to examine potential differences between noninvasive positive pressure ventilation and nasal high flow.ResultsDuring the study period, 3177 patients met inclusion criteria (40% invasive mechanical ventilation, 60% noninvasive respiratory support). Initial noninvasive respiratory support was not associated with a decreased hazard of in-hospital death (HR: 0.65, 95% CI: 0.35-1.2), but was associated with an increased hazard of discharge alive (HR: 2.26, 95% CI: 1.92-2.67). In-hospital death varied between the nasal high flow (HR 3.27, 95% CI: 1.43-7.45) and noninvasive positive pressure ventilation (HR 0.52, 95% CI 0.25-1.07), but both were associated with increased likelihood of discharge alive (nasal high flow HR 2.12, 95 CI: 1.25-3.57; noninvasive positive pressure ventilation HR 2.29, 95% CI: 1.92-2.74).ConclusionsThese data show that noninvasive respiratory support is not associated with reduced hazards of in-hospital death but is associated with hospital discharge alive.

OBJECTIVES: Guillain-Barré syndrome (GBS) and myasthenia gravis (MG) are the most common causes of acute neuromuscular respiratory failure resulting in ICU admission. This synthetic narrative review summarizes the evidence for the prediction and management of acute neuromuscular respiratory failure due to GBS and MG. DATA SOURCES: We searched PubMed for relevant literature and reviewed bibliographies of included articles for additional relevant studies. STUDY SELECTION: English-language publications were reviewed. DATA EXTRACTION: Data regarding study methodology, patient population, evaluation metrics, respiratory interventions, and clinical outcomes were qualitatively assessed. DATA SYNTHESIS: No single tool has sufficient sensitivity and specificity for the prediction of acute neuromuscular respiratory failure requiring mechanical ventilation. Multimodal assessment, integrating history, examination maneuvers (single breath count, neck flexion strength, bulbar weakness, and paradoxical breathing) and pulmonary function testing are ideal for risk stratification. The Erasmus GBS Respiratory Insufficiency Score is a validated tool useful for GBS. Noninvasive ventilation can be effective in MG but may not be safe in early GBS. Airway management considerations are similar across both conditions, but dysautonomia in GBS requires specific attention. Extubation failure is common in MG, and early tracheostomy may be beneficial for MG. Prolonged ventilatory support is common, and good functional outcomes may occur even when prolonged ventilation is required. CONCLUSIONS: Multimodal assessments integrating several bedside indicators of bulbar and respiratory muscle function can aid in evidence-based risk stratification for respiratory failure among those with neuromuscular disease. Serial evaluations may help establish a patient's trajectory and to determine timing of respiratory intervention. [ABSTRACT FROM AUTHOR]

[Display omitted] • Ginsenoside fraction from Panax ginseng decreased the acetylated protein levels of spliceosome in cardiomyocytes. • Ginsenoside Rb2 inhibited SF3A2 acetylation at lysine 10 to promote mitochondrial function against myocardial ischemic/reperfusion injury. • Ginsenoside Rb2 promoted Fscn1 alternative splicing to enhance mitochondrial respiration. • The decreased acetylation of SF3A2 (K 10) by ginsenoside Rb2 was mediated by p300 inhibition. Ginsenosides (GS) derived from Panax ginseng can regulate protein acetylation to promote mitochondrial function for protecting cardiomyocytes. However, the potential mechanisms of GS for regulating acetylation modification are not yet clear. This study aimed to explore the potential mechanisms of GS in regulating protein acetylation and identify ginsenoside monomer for fighting myocardial ischemia-related diseases. The 4D-lable free acetylomic analysis was employed to gain the acetylated proteins regulated by GS pretreatment. The co-immunoprecipitation assay, immunofluorescent staining, and mitochondrial respiration measurement were performed to detect the effect of GS or ginsenoside monomer on acetylated protein level and mitochondrial function. RNA sequencing, site-specific mutation, and shRNA interference were used to explore the downstream targets of acetylation modificationby GS. Cellular thermal shift assay and surface plasmon resonance were used for identifying the binding of ginsenoside with target protein. In the cardiomyocytes of normal, oxygen glucose deprivation and/or reperfusion conditions, the acetylomic analysis identified that the acetylated levels of spliceosome proteins were inhibited by GS pretreatment and SF3A2 acetylation at lysine 10 (K 10) was significantly decreased as a potential target of GS. Ginsenoside Rb2 was identified as one of the active ginsenoside monomers for reducing the acetylation of SF3A2 (K 10), which enhanced mitochondrial respiration against myocardial ischemic injury in in vivo and in vitro experiments. RNA-seq analysis showed that ginsenoside Rb2 promoted alternative splicing of mitochondrial function-related genes and the level of fascin actin-bundling protein 1 (Fscn1) was obviously upregulated, which was dependent on SF3A2 acetylation. Critically, thermodynamic, kinetic and enzymatic experiments demonstrated that ginsenoside Rb2 directly interacted with p300 for inhibiting its activity. These findings provide a novel mechanism underlying cardiomyocyte protection of ginsenoside Rb2 by inhibiting p300-mediated SF3A2 acteylation for promoting Fscn1 expression, which might be a promising approach for the prevention and treatment of myocardial ischemic diseases. [ABSTRACT FROM AUTHOR]

Aims: To investigate the effects of a telerehabilitation program on walking performance, lower and upper extremity function, fall frequency, respiratory function, and satisfaction in individuals with Duchenne muscular dystrophy (DMD). Methods: Thirty children (mean age 8.8 ± 4.2 years) were ambulant (Group 1), and 12 youth (18.5 ± 4.7 years) were non-ambulant (Group 2). The telerehabilitation program was applied by physiotherapists for 24 sessions (3 days/week). The 10-meter walking test, stand up from the supine position test, the modified upper extremity performance test, repetition of Lower and upper extremity movements, and the single breath count (SBC) test were administered. Fall frequency and satisfaction level were also recorded. Results: Significant improvement was found after telerehabilitation in upper extremity performance, repetition of lower and upper extremity movements, fall frequency, and SBC scores in Group 1. Changes in the 10-minute Walk and Stand Up from the Supine Position tests were not significant. There was a significant improvement in SBC scores in Group 2. Satisfaction with the service was 88%. Conclusions: The 8-week telerehabilitation program was effective in improving aspects of upper and lower extremity function, fall frequency, pulmonary function, and satisfaction levels in individuals with DMD. [ABSTRACT FROM AUTHOR]

Patients with serious illnesses often do not engage in discussions about end-of-life care decision-making, or do so reluctantly. These discussions can be useful in facilitating advance care planning and connecting patients to services such as palliative care that improve quality of life. Terror Management Theory, a social psychology theory stating that humans are motivated to resolve the discomfort surrounding their inevitable death, has been discussed in the psychology literature as an underlying basis of human decision-making and behavior. This paper explores how Terror Management Theory could be extended to seriously ill populations and applied to their healthcare decision-making processes and quality of care received. [ABSTRACT FROM AUTHOR]

To preserve the quality traits of late-harvested 'Galaxy' apples during extended storage, the effects of 1-methylcyclopropene (1-MCP) treatment and storage conditions on postharvest quality were analysed. Alongside quality measures, indicators like ethylene production, respiration rate, aminocyclopropane-1-carboxylic acid oxidase (ACO) activity, and membrane permeability were assessed. Apples were harvested at an optimal harvest date or later and stored for 7 months at 1°C under regular atmosphere or controlled atmosphere. Treatments with 1–MCP at 300, 600 or 900 nL L−1 were applied pre- or post-storage. After 7 days shelf-life, apples subjected to 1-MCP and controlled atmosphere exhibited reduced ethylene production, respiration rate, and ACO activity compared to untreated or regular atmosphere counterparts. While the time of 1-MCP application and its concentration did not impact the respiration rate during shelf-life, controlled atmosphere effectively decreased it. The combination of controlled atmosphere and 1–MCP pre-storage was most effective in lowering ACO activity. Irrespective of conditions, 1-MCP curtailed ethylene production, respiration rate, and ACO activity during shelf-life, alleviating firmness and acidity loss. Only controlled atmosphere preserved quality and minimised disorders for optimally harvested apples, not late-harvested ones. None of the treatments maintained late-harvested apples' quality after long-term storage plus shelf-life. [ABSTRACT FROM AUTHOR]

Background: Halitosis in children implies psychosocial repercussions. Risk factors associated with this condition are unclear, and detection methods are inaccurate. Aim: To quantify the levels of sulfur‐like compounds in children with asthma and healthy children from a novel validated assay, and to establish the risk factors related to halitosis. Design: One hundred and twenty‐eight individuals (63 healthy and 65 asthmatic) from 3 to 17 years of age were tested using a passive colorimetric sensor to measure the levels of sulfur‐like compounds in breath and saliva. Information was collected on oral hygiene habits, gingival and dental health, breathing type, and dental malocclusion. Results: The mean values of hydrogen sulfide were 4.0 ± 6.8 and 19.7 ± 12.2 ppbv (parts per billion in volume) in the control and asthmatic groups, respectively (p <.001). The presence of higher concentrations of sulfur compounds was significantly associated (p <.05) with the presence of gingival inflammation, tongue coating, dental plaque, mouth breathing, hypomineralization, age, tongue brushing, and the use of dental floss. Conclusion: The level of sulfur in breath and saliva was significantly higher in patients with asthma. These results can serve as a precedent to raise awareness among paediatricians and parents about oral hygiene care in children and adolescents. [ABSTRACT FROM AUTHOR]

Critiques such as Susan Sontag's Illness as Metaphor have encouraged the renunciation of metaphorical thinking about illness. This article suggests a level of discernment toward implicit interpretations of illness instead of an all-or-nothing removal of metaphor from the rhetoric surrounding illness. Rather than doing away with metaphorical thinking about illness in a total and absolute sense, the article reflects on illness metaphors to explore what insight they may have to impart about lived experiences of illness. With the help of literary expressions in Camus's The Plague, the article depicts ways that through a discerning attitude toward metaphorical thinking on illness, an elemental affirmation of being within the necessary limits on the human condition is given space to breathe. [ABSTRACT FROM AUTHOR]

Nasal respiratory disorders are linked to craniofacial anomalies and systemic dysfunctions. However, the implications of nasal respiratory disorders on brain development and their subsequent impact on brain functionalization remain largely unknown. Here, we describe that nasal obstruction from postnatal developmental stages in mice precipitates deficits in cerebellum-associated behaviors and compromised refinement and maturation of neural circuits in the cerebellum. We show that mice with nasal obstruction during developmental phases exhibit marked impairments in motor function and exhibit increased immobility time in forced swimming test. Additionally, we identified critical periods during which nasal respiration is essential for optimizing motor function and preserving mental health. Our study also reveals that nasal obstruction in mice disrupts the typical developmental process of synapse elimination in the cerebellum and hinders the normal transition of activity patterns in cerebellar Purkinje cell populations during development. Through comparing activity patterns in mouse models subjected to nasal obstruction at various stages, we suggest that the maturation of specific activity pattern among Purkinje cell populations is fundamental to the functional integrity of the cerebellum. Our findings highlight the indispensable role of adequate nasal respiration during development for the establishment and functional integrity of neural circuits, thereby significantly affecting brain function. Nasal obstruction during specific critical periods leads to motor deficits and depressive-like behaviors in mice, mediated by impaired synapse elimination and disrupted cerebellar activity patterns. [ABSTRACT FROM AUTHOR]

The growing demand for wearable healthcare devices has led to an urgent need for cost-effective, wireless and portable breath monitoring systems. However, it is essential to explore novel nanomaterials that combine state-of-the-art flexible sensors with high performance and sensing capabilities along with scalability and industrially acceptable processing. In this study, we demonstrate a highly efficient NiS2-based flexible capacitive sensor fabricated via a solution-processible route using a novel single-source precursor [Ni{S2P(OPr)2}2]. The developed sensor could precisely detect the human respiration rate and exhibit rapid responsiveness, exceptional sensitivity and selectivity at ambient temperatures, with an ultra-fast response and recovery. The device effectively differentiates the exhaled breath patterns including slow, fast, oral and nasal breath, as well as post-exercise breath rates. Moreover, the sensor shows outstanding bending stability, repeatability, reliable and robust sensing performance and is capable of contactless sensing. The sensor was further employed with a user-friendly wireless interface to facilitate smartphone-enabled real-time breath monitoring systems. This work opens up numerous avenues for cost-effective, sustainable and versatile sensors with potential applications for Internet of Things-based flexible and wearable electronics. This article is part of the theme issue 'Celebrating the 15th anniversary of the Royal Society Newton International Fellowship'. [ABSTRACT FROM AUTHOR]

Misregistration between CT and PET in PET/CT is mainly caused by respiratory motion or irregular respiration during the CT scan in PET/CT. Other than repeat CT, repeat PET/CT, or data-driven gated (DDG) CT, there is no practical approach to mitigate the misregistration artifacts and subsequent CT attenuation correction (CTAC) of the PET data. DDG PET derives a respiratory motion model based on the multiple phases of PET images without hardware gating and it allows for a potential correction of the misregistration artifacts based on the respiratory motion model. The purpose of this commentary was to compare the recent two publications on matching the random phase of helical CT with one of the PET phases derived from the motion model of DDG PET and warping the misregistered helical CT for CTAC of and registration with PET or DDG PET. The two publications were similar in methodology. However, the data sets used for the comparison were different and could potentially impact their conclusions. [ABSTRACT FROM AUTHOR]

Background and Purpose Experimental Approach Key Results Conclusions and Implications Cannabis stimulates several G‐protein‐coupled‐receptors and causes bradycardia and hypotension upon sustained consumption. Moreover, in vitro studies suggest an interference of cannabinoid‐signalling with cardiomyocyte contractility and hypertrophy. We aimed at revealing a functional contribution of the cannabinoid‐sensitive receptor GPR55 to cardiomyocyte homeostasis and neurohumorally induced hypertrophy in vivo.Gpr55−/− and wild‐type (WT) mice were characterized after 28‐day angiotensin II (AngII; 1·μg·kg−1 min−1) or vehicle infusion. In isolated adult Gpr55−/− and WT cardiomyocytes, mitochondrial function was assessed under naïve conditions, while cytosolic Ca2+ handling was additionally determined following application of the selective GPR55 antagonist CID16020046.Gpr55 deficiency did not affect angiotensin II (AngII) mediated hypertrophic growth, yet, especially in females, it alleviated maladaptive pro‐hypertrophic and ‐inflammatory gene expression and improved inotropy and adrenergic responsiveness compared to WT. In‐depth analyses implied increased cytosolic Ca2+ concentrations and transient amplitudes, and accelerated sarcomere contraction kinetics in Gpr55−/− myocytes, which could be mimicked by GPR55 blockade with CID16020046 in female WT cells. Moreover, Gpr55 deficiency up‐regulated factors involved in glucose and fatty acid transport independent of the AngII challenge, accelerated basal mitochondrial respiration and reduced basal protein kinase (PK) A, G and C activity and phospholemman (PLM) phosphorylation.Our study suggests GPR55 as crucial regulator of cardiomyocyte hypertrophy and homeostasis presumably by regulating PKC/PKA‐PLM and PKG signalling, and identifies the receptor as potential target to counteract maladaptation, adrenergic desensitization and metabolic shifts as unfavourable features of the hypertrophied heart in females. [ABSTRACT FROM AUTHOR]

The document is a contents list for the journal "Lab on a Chip," which focuses on devices and applications at the micro- and nanoscale. It includes a range of articles on various topics, such as microfluidic technologies, CRISPR diagnostics, drug delivery, and 3D printing. The journal aims to connect the world with the chemical sciences and is published by The Royal Society of Chemistry. The document also mentions approved training courses offered by the society. [Extracted from the article]

In disciplines like toxicology and pharmacology, oxygen (O2) respiration is a universal metric for evaluating the effects of chemicals across various model systems, including mammalian and microalgal cells. However, for these cells the common practice is to segregate populations into control and exposure groups, which assumes direct equivalence in their responses and does not take into account heterogeneity among individual cells. This lack of resolution impedes our ability to precisely investigate differences among experimental groups with small or limited sample sizes. To overcome this barrier, we introduce SlipO2Chip, an innovative glass microfluidic platform for precisely quantifying single-cell O2 respiration in the coordinated absence and presence of chemical solutes. SlipO2Chip comprises a wet-etched fused silica channel plate on the top and a dry-etched borosilicate microwell plate at the bottom. The microwells are coated with Pt(II) meso-tetra(pentafluorophenyl)porphine (PtTFPP), an O2 sensing optode material and an O2-independent reference dye. A custom 3D-printed holder facilitates the controlled horizontal movement ('slipping') of the channel plate over the microwell plate, thereby establishing or disrupting the fluid path over microwells. Collectively, these design elements enable the immobilization of single-cells in microwells, their exposure to controlled fluid flows, the coordinated opening and closing of microwells and repeated measurements of single-cell O2 respiration. Uniquely, by sequentially executing opening and closing it becomes possible to measure single-cell respiration prior to and after exposure to chemical solutes. In a proof-of-concept application, we utilized SlipO2Chip to measure the impact of increasing exposures of the marine bacterial signal 2-heptyl-4-quinolone (HHQ) on the dark respiration of the diatom Ditylum brightwellii at single-cell resolution. Results revealed a concentration-dependent decrease in per-cell O2 dark respiration, with a maximum reduction of 40.2% observed at HHQ concentrations exceeding 35.5 μM, and a half-maximal effective concentration (EC50) of 5.8 μM, consistent with that obtained via conventional bulk respiration methods. The ability of SlipO2Chip to sequentially assess the effects of chemical substances on single-cell O2 metabolism is advantageous for research where sample volumes are limited, such as clinical biopsies, studies involving rare microbial isolates, and toxicological studies aiming to address exposure effects while accounting for cell-to-cell variability. [ABSTRACT FROM AUTHOR]

Background: Mouth breathing (MB), a risk factor of oral dysbiosis and halitosis, is linked with craniofacial anomalies and pediatric obstructive sleep apnea. Here, we aimed to analyze tongue microbiota in children from the perspective of their breathing pattern before/during orthodontic treatment. Methods: This prospective case–control study included 30 children with orthodontic anomalies, 15 with MB and 15 with nasal breathing (NB), matched by age, sex, and body mass index. All underwent orthodontic examination and sleep apnea monitoring. Tongue swabs were collected before starting (timepoint M0) and approx. six months into the orthodontic therapy (timepoint M6). Oral candidas and bacteriome were analyzed using mass spectrometry technique and 16S rRNA sequencing, respectively. Results: MB was associated with higher apnea–hypopnea index. At M0, oral candidas were equally present in both groups. At M6, Candida sp. were found in six children with MB but in none with NB. No significant differences in bacterial diversity were observed between groups and timepoints. However, presence/relative abundance of genus Solobacterium was higher in children with MB than NB at M0. Conclusions: Significant links between MB and the presence of genus Solobacterium (M0) as well as Candida sp. (M6) were found in children with orthodontic anomalies, highlighting the risk of halitosis in them. [ABSTRACT FROM AUTHOR]

Background: This narrative review was written by an expert panel to the members of the jury to help in the development of clinical practice guidelines on oxygen therapy. Results: According to the expert panel, acute hypoxemic respiratory failure was defined as PaO2 < 60 mm Hg or SpO2 < 90% on room air, or PaO2/FiO2 ≤ 300 mm Hg. Supplemental oxygen should be administered according to the monitoring of SpO2, with the aim at maintaining SpO2 above 92% and below 98%. Noninvasive respiratory supports are generally reserved for the most hypoxemic patients with the aim of relieving dyspnea. High-flow nasal cannula oxygen (HFNC) seems superior to conventional oxygen therapy (COT) as a means of avoiding intubation and may therefore be should probably be used as a first-line noninvasive respiratory support in patients requiring more than 6 L/min of oxygen or PaO2/FiO2 ≤ 200 mm Hg and a respiratory rate above 25 breaths/minute or clinical signs of respiratory distress, but with no benefits on mortality. Continuous positive airway pressure (CPAP) cannot currently be recommended as a first-line noninvasive respiratory support, since its beneficial effects on intubation remain uncertain. Despite older studies favoring noninvasive ventilation (NIV) over COT, recent clinical trials fail to show beneficial effects with NIV compared to HFNC. Therefore, there is no evidence to support the use of NIV or CPAP as first-line treatment if HFNC is available. Clinical trials do not support the hypothesis that noninvasive respiratory supports may lead to late intubation. The potential benefits of awake prone positioning on the risk of intubation in patients with COVID-19 cannot be extrapolated to patients with another etiology. Conclusions: Whereas oxygen supplementation should be initiated for patients with acute hypoxemic respiratory failure defined as PaO2 below 60 mm Hg or SpO2 < 90% on room air, HFNC should be the first-line noninvasive respiratory support in patients with PaO2/FiO2 ≤ 200 mm Hg with increased respiratory rate. Further studies are needed to assess the potential benefits of CPAP, NIV through a helmet and awake prone position in patients with acute hypoxemic respiratory failure not related to COVID-19. [ABSTRACT FROM AUTHOR]

Colonisation of novel habitats are important events in evolution, but the factors that initially prompt such ecological transitions are often unknown. The invasion of land by fish is an extreme habitat transition that offers an opportunity to empirically investigate the causes of major ecological transitions. The intertidal ecotone—and rock pools in particular—have been an important staging ground for transitions onto land. Classic hypotheses focus on the adverse abiotic conditions of rock pools at low tide as the instigator of fish voluntarily stranding themselves out of water, which can then lead to the evolution of an amphibious lifestyle. To test these hypotheses, we studied the abiotic conditions of 54 rock pools on the island of Guam where there are various species of aquatic, amphibious and terrestrial blenny fishes. We found little support for the expected deterioration of abiotic conditions in standing pools at low tide (salinity, pH and oxygen), and fish were not seen to be excluded from those pools that were found to exhibit poor abiotic conditions (temperature, salinity and pH). Hypoxia was the only factor that might account for the absence of blennies from certain rock pools. Next, we experimentally measured oxygen depletion by an aquatic, mildly amphibious and highly amphibious species of blenny found on Guam in a simulated rockpool to infer the proportion of rock pools at low tide outside the tolerable range of blennies. Rock pools were found to have oxygen levels within the requirements of most blennies and those of other marine fishes reported in the literature. We conclude that the abiotic environment of rock pools alone was unlikely to have instigated the evolution of amphibious behaviour in blennies, at least on Guam. Instead, the broad range of abiotic conditions experienced in rock pools suggests these conditions could have primed amphibious blennies to better endure the novel conditions on land. Any ecotone typified by fluctuations or gradients in abiotic conditions is likely a key transitional environment for the invasion of novel habitats and, as such, are an important location for adaptive evolution and species diversification. Read the free Plain Language Summary for this article on the Journal blog. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has challenged the current paradigm of clinical and community-based disease detection. We present a multimodal wearable sensor system paired with a two-minute, movement-based activity sequence that successfully captures a snapshot of physiological data (including cardiac, respiratory, temperature, and percent oxygen saturation). We conducted a large, multi-site trial of this technology across India from June 2021 to April 2022 amidst the COVID-19 pandemic (Clinical trial registry name: International Validation of Wearable Sensor to Monitor COVID-19 Like Signs and Symptoms; NCT05334680; initial release: 04/15/2022). An Extreme Gradient Boosting algorithm was trained to discriminate between COVID-19 infected individuals (n = 295) and COVID-19 negative healthy controls (n = 172) and achieved an F1-Score of 0.80 (95% CI = [0.79, 0.81]). SHAP values were mapped to visualize feature importance and directionality, yielding engineered features from core temperature, cough, and lung sounds as highly important. The results demonstrated potential for data-driven wearable sensor technology for remote preliminary screening, highlighting a fundamental pivot from continuous to snapshot monitoring of cardiorespiratory illnesses. [ABSTRACT FROM AUTHOR]

Euphausiids, commonly known as krill, are crucial contributors to the ocean's active carbon pump, impacting carbon export and sequestration through their diel vertical migration. These organisms feed on organic matter in the epipelagic layer at night and release inorganic carbon in the mesopelagic layer during the day via respiration. Measuring respiration in the mesopelagic layer is challenging due to the difficulties in obtaining direct measurements, as well as the lack of comprehensive data, and reliance on conservative estimates. The measurement of the electron transfer system (ETS) activity is used as a proxy to assess respiration in the mesopelagic layer. However, accurate calibration of respiration rates and ETS activity is imperative through experimental measurements and empirical data. Here, we compared the respiration rates with their respective ETS activities of different species of euphausiids captured at night in the epipelagic layer of the Atlantic Ocean along a latitudinal (42-29°N, 25°W) and a longitudinal (25-13°W, 29°N) transect. Our results revealed a spatial trend in respiration rates, and consequently in ETS activities, with rates decreasing southward and increasing slightly towards the African upwelling region. The Generalized Additive Model (GAM) demonstrated that epipelagic oxygen concentration, chlorophyll a, and the interaction between epipelagic temperature and mesopelagic oxygen concentration significantly influenced euphausiids respiration rates. Furthermore, we observed a strong correlation between respiration and specific ETS activities, with R/ETS ratios exceeding the conservative value of 0.5, which is typically used to estimate respiratory flux. [ABSTRACT FROM AUTHOR]

It remains unclear whether feedback from group III/IV muscle afferents is of continuous significance for regulating the pulmonary response during prolonged (>5 min), steady‐state exercise. To elucidate the influence of these sensory neurons on hyperpnoea, gas exchange efficiency, arterial oxygenation and acid–base balance during prolonged locomotor exercise, 13 healthy participants (4 females; 21 (3) years, V̇O2max${{\dot{V}}_{{{{\mathrm{O}}}_{\mathrm{2}}}{\mathrm{max}}}}$: 46 (8) ml/kg/min) performed consecutive constant‐load cycling bouts at ∼50% (20 min), ∼75% (20 min) and ∼100% (5 min) of V̇O2max${{\dot{V}}_{{{{\mathrm{O}}}_{\mathrm{2}}}{\mathrm{max}}}}$ with intact (CTRL) and pharmacologically attenuated (lumbar intrathecal fentanyl; FENT) group III/IV muscle afferent feedback from the legs. Pulmonary responses were continuously recorded and arterial blood (radial catheter) periodically collected throughout the exercise. Pulmonary gas exchange efficiency was evaluated using the alveolar‐arterial PO2${{P}_{{{{\mathrm{O}}}_{\mathrm{2}}}}}$ difference (A−aDO2${\mathrm{A - a}}{{D}_{{{{\mathrm{O}}}_{\mathrm{2}}}}}$). There were no differences in any of the variables of interest between conditions before the start of the exercise. Pulmonary ventilation was up to 20% lower across all intensities during FENT compared to CTRL exercise (P < 0.001) and this hypoventilation was accompanied by an up to 10% lower arterial PO2${{P}_{{{{\mathrm{O}}}_{\mathrm{2}}}}}$ and a 2–4 mmHg higher PCO2${{P}_{{\mathrm{C}}{{{\mathrm{O}}}_{\mathrm{2}}}}}$ (both P < 0.001). The exercise‐induced widening of A−aDO2${\mathrm{A - a}}{{D}_{{{{\mathrm{O}}}_{\mathrm{2}}}}}$ was up to 25% larger during FENT compared to CTRL (P < 0.001). Importantly, the differences developed within the first minute of each stage and persisted, or further increased, throughout the remainder of each bout. These findings reflect a critical and time‐independent significance of feedback from group III/IV leg muscle afferents for continuously regulating the ventilatory response, gas exchange efficiency, arterial oxygenation and acid–base balance during human locomotion. Key points: Feedback from group III/IV leg muscle afferents reflexly contributes to hyperpnoea during short duration (i.e. <5 min) locomotor exercise.Whether continuous feedback from these sensory neurons is obligatory to ensure adequate pulmonary responses during steady‐state exercise of longer duration remains unknown.Lumbar intrathecal fentanyl was used to attenuate the central projection of group III/IV leg muscle afferents during prolonged locomotor exercise (i.e. 45 min) at intensities ranging from 50% to 100% of V̇O2max${{\dot{V}}_{{{{\mathrm{O}}}_{\mathrm{2}}}{\mathrm{max}}}}$.Without affecting the metabolic rate, afferent blockade compromised pulmonary ventilation and gas exchange efficiency, consistently impairing arterial oxygenation and facilitating respiratory acidosis throughout exercise.These findings reflect the time‐independent significance of feedback from group III/IV muscle afferents for regulating exercise hyperpnoea and gas exchange efficiency, and thus for optimizing arterial oxygenation and acid–base balance, during prolonged human locomotion. [ABSTRACT FROM AUTHOR]

Healthcare sensing devices enable continuous monitoring of diverse biosignals, such as respiration, heartbeat, temperature, inflammation, Electroencephalogram (EEG), and biomechanical movement, contributing to the management of health conditions and early diagnosis of diseases. However, clinically available tools have several limitations for real‐time measurement of biosignals in non‐hospital environments owing to their cumbersome, complex designs, and rigidity. To address these limitations, there has been a growing body of research that explores flexible and soft electronics for healthcare applications, which feature high mechanical compliance and adaptability. Especially, sensing devices based on fiber structures have attracted significant attention due to high flexibility, lightweight design, effective workspace and unique structural adaptability. Moreover, 1D sensing devices can be seamlessly integrated into garments and the human body with complex structures without any unconformity. In this perspective, The fabrication and electrical functionalization of fiber substrates and focus on recent advances in various fiber‐based sensing systems for strain, pressure, temperature, pH, biomarkers, and neural activity is explored. Additionally, biodegradable fiber‐based sensing devices as future healthcare technologies are briefly discussed. Finally, this article provides a summary and outlook on the remaining challenges for current fiber‐based sensing devices. [ABSTRACT FROM AUTHOR]

Aging is usually accompanied by excessive body fat gain, leading to increased susceptibility to comorbidities. This study aimed to explore an unexpected function for the eukaryotic initiation factor‐2α (eIF2α) during aging. Reducing the eIF2α dose led to a reconfiguration of the metabolic equilibrium, promoting catabolism, facilitating lipolysis, and decreasing body fat accumulation while maintaining healthy glucose and lipid metabolism during aging. Specifically, eIF2α enhanced the expression of distinct messenger RNAs encoding mitochondrial electron transport chain proteins at the translation level. The mitochondrial respiration increased in eIF2α heterozygotes, even during aging. Deceleration of translation was demonstrated as a conserved mechanism for promoting longevity across various species. Our findings demonstrated that the restriction of translation by reducing eIF2α expression could fend off multiple tissue damage and improve metabolic homeostasis during aging. Hence, eIF2α was a crucial target for benefiting mammalian aging achieving delayed mammalian aging. [ABSTRACT FROM AUTHOR]

Objectives: This study explored the experiences of second-grade children and their teachers who participated in a mind–body program to understand its impact on their development. Methods: A qualitative descriptive study was conducted. Student data were collected through seven focus groups, and semi-structured interviews were conducted with tutors in December 2021. Data analysis was performed following COREQ guidelines. Results: Three themes were generated: (1) competitiveness and restlessness in children: something needs to be done; (2) seeds sown and fruits harvested; and (3) it is necessary to advance from the occasional to the structural. Participants reported positive changes in areas of their development such as self-regulation, relaxation, attention capacity, and stress reduction. Improvements in interpersonal relationships and social skills were also observed. Conclusions: These improvements in emotional well-being and social skills highlight the importance of this type of intervention in the school environment. [ABSTRACT FROM AUTHOR]

Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disease that results in death within 2–5 years of diagnosis. Respiratory failure is the most common cause of death in ALS. Mutations in the transactive response DNA binding protein 43 (TDP-43) encoded by the TARDBP gene are associated with abnormal cellular aggregates in neurons of patients with both familial and sporadic ALS. The role of these abnormal aggregates on breathing is unclear. Since respiratory failure is a major cause of death in ALS, we sought to determine the role of TDP-43 mutations on the respiratory motor unit in the Prp-hTDP43A315T mouse model – a model that expresses human TDP-43 containing the A315T mutation. We assessed breathing using whole-body plethysmography, and investigated neuropathology in hypoglossal and phrenic respiratory motor units. Postmortem studies included quantification of hypoglossal and putative phrenic motor neurons, activated microglia and astrocytes in respiratory control centers, and assessment of hypoglossal and phrenic nerves of TDP43A315T mice. The male TDP43A315T mice display an early onset of rapid progression of disease, and premature death (less than 15 weeks) compared to control mice and compared to female TDP43A315T mice who die between 20 and 35 weeks of age. The TDP43A315T mice have progressive and profound breathing deficits at baseline and during a respiratory challenge. Histologically, hypoglossal and putative phrenic motor neurons of TDP43A315T mice are decreased and have increased microglial and astrocyte activation, indicating pronounced neurodegeneration and neuroinflammation. Further, there is axonopathy and demyelination in the hypoglossal and phrenic nerve of TDP43A315T mice. Thus, the TDP-43A315T mice have significant respiratory pathology and neuropathology, which makes them a useful translatable model for the study of novel therapies on breathing in ALS. [ABSTRACT FROM AUTHOR]

The influence of cardiac phases on cognitive and sensorimotor functions is noteworthy. Specifically, during systole, as opposed to diastole, there is an observed enhancement in tasks demanding the suppression of instructed responses. This suggests that systole contributes to inhibitory control in motor functions. However, the extent to which systolic inhibition is significant in volitional free‐choice actions, such as choosing to execute or refrain from a cue‐initiated response, remains to be clarified. To fill this gap in the current literature, the purpose of this study was to test whether during the systole phase, compared with the diastole phase, the tendency to enact volitional actions decreased due to the systolic inhibitory effect. We used a modified version of the Go/No‐Go task with an added condition for volitional free‐choice actions, where participants could decide whether to respond or not, to test whether systolic inhibition could affect the volitional decision to act. The results showed that participants' responses were less frequent in systole than in diastole in the volitional action condition. Then, to test the robustness of the cardiac effect on volitional actions, we used two established manipulations: the Straw Breathing Manipulation and the Cold Pressor Test, which were able to induce anxiety and increase the heart rate, respectively. Results showed that the systole/diastole difference in the number of volitional action trials in which participants decided to respond tended to remain the same despite all manipulations. Overall, our results provide convergent evidence for the effect of the heart on the decision to act, an effect that appears independent of manipulations of both the physiological and psychological state of the individual. [ABSTRACT FROM AUTHOR]

Physiological regulation strategies can be effective in reducing anxiety. However, while these strategies are often learned and practised under low‐stress conditions, they are more likely to be required under conditions of high stress. We created virtual reality (VR) biofeedback games to both teach participants a breathing technique and then practise that technique under stress. We present two studies: the first provides a proof of concept, demonstrating that participants can apply the breathing technique during stress, with a significant lowering of both respiration rate and increase in heart rate variability (HRV) under stress (p < .001). The second study explicitly evaluated the effectiveness of training by comparing trained and untrained groups. Training was associated with a significantly greater HRV (p = .008) under stress. In within‐group comparisons of HRV during stress compared to a baseline stressor presented before training, the trained group showed a significantly greater increase compared to untrained controls (p = .025). Our results show the feasibility and potential effectiveness of VR‐based games for biofeedback training under experimentally applied stress. This may offer the opportunity for clinical techniques to more closely reflect the circumstances under which those techniques will be required. [ABSTRACT FROM AUTHOR]

The overexpression of major histocompatibility complex (MHC) I on the surface of muscle fibers is a characteristic hallmark of the idiopathic inflammatory myopathies (IIMs), collectively termed myositis. Alongside MHC‐I overexpression, subtypes of myositis, display a distinct type I interferon (IFN) signature. This study examined the combinational effects of elevated MHC‐I and type I IFNs (IFNα/β) on mitochondrial function, as mitochondrial dysfunction is often seen in IIMs. Human skeletal muscle myoblasts were transfected with an MHC‐I isoform using the mammalian HLA‐A2/Kb vector. Mitochondrial respiration, mitochondrial membrane potential, and reactive oxygen/nitrogen species generation were assessed with or without IFNα and IFNβ. We show that MHC‐I overexpression in human skeletal muscle myoblasts led to decreased basal glycolysis and mitochondrial respiration, cellular spare respiratory capacity, adenosine triphosphate‐linked respiration, and an increased proton leak, which were all exaggerated by type I IFNs. Mitochondrial membrane depolarization was induced by MHC‐I overexpression both in absence and presence of type I IFNs. Human myoblasts overexpressing MHC‐I showed elevated nitric oxide generation that was abolished when combined with IFN. MHC‐I on its own did not result in an increased reactive oxygen species (ROS) production, but IFN on their own, or combined with MHC‐I overexpression did induce elevated ROS generation. Surprisingly, we observed no gross changes in mitochondrial reticular structure or markers of mitochondrial dynamics. We present new evidence that MHC‐I overexpression and type I IFNs aggravate the effects each has on mitochondrial function in human skeletal muscle cells, providing novel insights into their mechanisms of action and suggesting important implications in the further study of myositis pathogenesis. [ABSTRACT FROM AUTHOR]

Introduction: The incorporation of health-related sensors in wearable devices has increased their use as essential monitoring tools for a wide range of clinical applications. However, the signals obtained from these devices often present challenges such as artifacts, spikes, high-frequency noise, and data gaps, which impede their direct exploitation. Additionally, clinically relevant features are not always readily available. This problem is particularly critical within the H2020 BRAINTEASER project, funded by the European Community, which aims at developing models for the progression of Multiple Sclerosis (MS) and Amyotrophic Lateral Sclerosis (ALS) using data from wearable devices. Methods: The objective of this study is to present the automated pipeline developed to process signals and extract features from the Garmin Vivoactive 4 smartwatch, which has been chosen as the primary wearable device in the BRAINTEASER project. The proposed pipeline includes a signal processing step, which applies retiming, gap-filling, and denoising algorithms to enhance the quality of the data. The feature extraction step, on the other hand, utilizes clinical partners' knowledge and feedback to select the most relevant variables for analysis. Results: The performance and effectiveness of the proposed automated pipeline have been evaluated through pivotal beta testing sessions, which demonstrated the ability of the pipeline to improve the data quality and extract features from the data. Further clinical validation of the extracted features will be performed in the upcoming steps of the BRAINTEASER project. Discussion: Developed in Python, this pipeline can be used by researchers for automated signal processing and feature extraction from wearable devices. It can also be easily adapted or modified to suit the specific requirements of different scenarios. [ABSTRACT FROM AUTHOR]

Successful implementation of remote monitoring of vital signs outside of the hospital setting hinges on addressing three crucial unmet needs: longer-term wear, skin comfort and signal quality. Earlier, we developed a Health Patch research platform that uses self-adhesive dry electrodes to measure vital digital biomarkers. Here, we report on the analytical validation for heart rate, heart rate variability and respiration rate. Study design included n = 25 adult participants with data acquisition during a 30-minute exercise protocol involving rest, squats, slow, and fast cycling. The Shimmer3 ECG Unit and Cosmed K5, were reference devices. Data analysis showed good agreement in heart rate and marginal agreement in respiratory rate, with lower agreement towards higher respiratory rates. The Lin's concordance coefficient was 0.98 for heart rate and 0.56 for respiratory rate. Heart rate variability (RMSSD) had a coefficient of 0.85. Participants generally expressed a positive experience with the technology, with some minor irritation from the medical adhesive. The results highlighted potential of this technology for short-to-medium term clinical use for cardiorespiratory health, due to its reliability, accuracy, and compact design. Such technology could become instrumental for remote monitoring providing healthcare professionals with continuous data, remote assessment and enhancing patient outcomes in cardiorespiratory health management. [ABSTRACT FROM AUTHOR]

Background: Some children with a deviated nasal septum show no symptoms, but up to 30% have breathing problems. Septal deviation is usually caused by microtrauma during delivery, but in severe cases, trauma is the main cause. Many people fail to recognize septal damage after trauma, &children with untreated septal abnormalities often have severe problems. Thus, we can see why symptoms increase with age. Objective: Through the available literature, this review seeks to establish the effect of nasal septoplasty among pediatric patients on nasal breathing and the need for revision surgery. Subjects and methods: Prospective and retrospective studies published in peer-reviewed journals including clinical trials, cohort studies, cases, and cross-sectional. Results: Five studies. 4, 5, 6, 8, 9 151 people assessed NOSE pre- and post-pediatric septoplasty. The pooled mean NOSE score difference between pre- and postoperative evaluations was -50.26 (95% CI, -62.55 to -37.97), showing a substantial decrease. In Saeed et al. (Ann Coll Med Mosul June 45(1):70-79, 2023), mean differences ranged from -71 points (95% CI, -75.41 to -66.59) to -30 points in Lee (2017). Surgicalft benefits were regularly shown. Each year of follow-up did not substantially lower NOSE score improvement by 0.39 (SE = 0.29; P = 0.17; I2 = 89.6%) in a meta-regression analysis in children, NOSE score improvement increased by 6.36 per year (SE = 1.14; P = < 0.001; I2 = 34.45%). In meta-regression research on revision rates following pediatric septoplasty, each year of follow-up raised the rate by 0.13 (SE 0.02; P < 0.001; I2 = 4.78%). However, revision rates were not significantly associated with each year of pediatric age (coefficient, -0.39; SE 0.22; P = 0.075; I2 = 86.25%). Conclusion: This comprehensive meta-analysis shows that septoplasty improves nasal airway function and obstruction in children. NOSE Scale disease-specific QOL improved significantly after pediatric septoplasty. According to the meta-regression analysis, each year of follow-up time resulted in a 0.39 drop in NOSE score improvement (SE = 0.29; P = 0.17; I2 = 89.6%). Each year of pediatric age increased NOSE score improvement by 6.36. [ABSTRACT FROM AUTHOR]

To improve our understanding of the carbon balance, it is significant to study long-term variations of all components of carbon exchange and their driving factors. Gross primary production (GPP), respiration (Re), and net ecosystem productivity (NEP) from the hourly to the annual sums in a subtropical coniferous forest in China during 2003–2017 were calculated using empirical models developed previously in terms of PAR (photosynthetically active radiation), and meteorological parameters, GPP, Re, and NEP were calculated. The calculated GPP, Re, and NEP were in reasonable agreement with the observations, and their seasonal and interannual variations were well reproduced. The model-estimated annual sums of GPP and Re over 2003–2017 were larger than the observations of 11.38% and 5.52%, respectively, and the model-simulated NEP was lower by 34.99%. The GPP, Re, and NEP showed clear interannual variations, and both the calculated and the observed annual sums of GPPs increased on average by 1.04% and 0.93%, respectively, while the Re values increased by 4.57% and 1.06% between 2003 and 2017. The calculated and the observed annual sums of NEPs/NEEs (net ecosystem exchange) decreased/increased by 1.04%/0.93%, respectively, which exhibited an increase of the carbon sink at the experimental site. During the period 2003–2017, the annual averages of PAR and the air temperature decreased by 0.28% and 0.02%, respectively, while the annual average water vapor pressure increased by 0.87%. The increase in water vapor contributed to the increases of GPP, Re, and NEE in 2003–2017. Good linear and non-linear relationships were found between the monthly calculated GPP and the satellite solar-induced fluorescence (SIF) and then applied to compute GPP with relative biases of annual sums of GPP of 5.20% and 4.88%, respectively. Large amounts of CO2 were produced in a clean atmosphere, indicating a clean atmospheric environment will enhance CO2 storage in plants, i.e., clean atmosphere is beneficial to human health and carbon sink, as well as slowing down climate warming. [ABSTRACT FROM AUTHOR]

(1) Background: Liver damage is an important component of acute COVID-19, and the advancement of preexisting liver disease is associated with a worse prognosis; (2) Methods: A nationwide retrospective study including 7444 patients aimed to evaluate levels of selected markers of liver damage and disease advancement and their association with mortality and mechanical ventilation (MV); (3) Results: Elevation of the following markers in multivariate models were associated with increased odds of mortality: Alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyltransferase (GGT), lactate dehydrogenase (LDH), fibrosis-4 score (FIB-4), AST-to-platelet ratio index (APRI), and decreased levels of platelet count (PLT). Elevated levels of AST, LDH, APRI, FIB-4, and the AST/ALT ratio and decreased levels of PLT were associated with increased odds of MV in multivariate models. The best predictive accuracy against mortality was achieved with FIB-4 with AUC = 0.733 (95% CI, 0.718–0.749) at the optimal cut-off point of 2.764, while against MV was achieved with LDH with AUC = 0.753 (95% CI, 0.727–0.778) at the optimal cut-off point of 449.5 IU/L. (4) Conclusions: Our study confirms that the advancement of liver damage contributes to a worse prognosis in COVID-19 patients. Markers for liver damage and the advancement of liver disease can provide predictive value in clinical practice among COVID-19 patients. [ABSTRACT FROM AUTHOR]

Understanding how macroalgal forests will respond to environmental change is critical for predicting future impacts on coastal ecosystems. Although measures of adult macroalgae physiological responses to environmental stress are advancing, measures of early life‐stage physiology are rare, in part due to the methodological difficulties associated with their small size. Here we tested a novel, high‐throughput method (rate of oxygen consumption and production; V̇O2$$ \dot{V}{\mathrm{O}}_2 $$) via a sensor dish reader microplate system to rapidly measure physiological rates of the early life stages of three habitat‐forming macroalgae, the kelp Ecklonia radiata and the fucoids Hormosira banksii and Phyllospora comosa. We measured the rate of O2 consumption (respiration) and O2 production (net primary production) to then calculate gross primary production (GPP) under temperatures representing their natural thermal range. The V̇O2$$ \dot{V}{\mathrm{O}}_2 $$ microplate system was suitable for rapidly measuring physiological rates over a temperature gradient to establish thermal performance curves for all species. The V̇O2$$ \dot{V}{\mathrm{O}}_2 $$ microplate system proved efficient for measures of early life stages of macroalgae ranging in size from approximately 50 μm up to 150 mm. This method has the potential for measuring responses of early life stages across a range of environmental factors, species, populations, and developmental stages, vastly increasing the speed, precision, and efficacy of macroalgal physiological measures under future ocean change scenarios. [ABSTRACT FROM AUTHOR]

Background: When the diaphragm moves from its level throughout complete expiration to its level during full inhalation, this movement is referred to as diaphragmatic excursion for short. An evaluation of the value of the diaphragmatic excursion time index & the diaphragmatic rapid shallow breathing index, both of which were evaluated using ultrasonography, in order to forecast the likelihood of successful weaning from mechanical ventilation & extubation. Methods: For the purpose of predicting the probability of effective weaning from mechanical ventilation & extubation, an assessment of the value of the diaphragmatic excursion time index and the diaphragmatic fast shallow breathing index was performed. Both of these indices were analysed using ultrasonography. Results: 99 cases were enrolled in this study, there was not a statistically significant distinction amongst the three categories that were investigatedas regards Ventilator hours till SBT p= 0.577. DETI and DRSBI at 30 minutes were more significant predictors of successful weaning than at the beginning of the SBT. Regarding DETI at 30 min, AUC was 0.965, Cutoff value was 1.3, Sensitivity was 99%and Specificity was 88.2%, while DRSBI at 30 min, AUC was 0.895, Cutoff value was 1.07, Sensitivity was 97.2% & Specificity was 86.5%. Conclusion: When it comes to predicting the result of weaning, comparatively, the diagnostic accuracy of the DETI and DRSBI were better than that of the standard RSBI in supporting clinical decision-making regarding the release of patients from mechanical ventilation. [ABSTRACT FROM AUTHOR]

Autonomous generation of energy, specifically adenosine triphosphate (ATP), is critical for sustaining the engineered functionalities of synthetic cells constructed from the bottom‐up. In this mini‐review, we categorize studies on ATP‐producing synthetic cells into three different approaches: photosynthetic mechanisms, mitochondrial respiration mimicry, and utilization of non‐conventional approaches such as exploiting synthetic metabolic pathways. Within this framework, we evaluate the strengths and limitations of each approach and provide directions for future research endeavors. We also introduce a concept of building ATP‐generating synthetic organelle that will enable us to mimic cellular respiration in a simpler way than current strategies. This review aims to highlight the importance of energy self‐production in synthetic cells, providing suggestions and ideas that may help overcome some longstanding challenges in this field. [ABSTRACT FROM AUTHOR]

Mycobacterium abscessus (Mab) is highly drug resistant, and understanding regulation of antibiotic resistance is critical to future antibiotic development. Regulatory mechanisms controlling Mab's β‐lactamase (BlaMab) that mediates β‐lactam resistance remain unknown. S. aureus encodes a prototypical protease‐mediated two‐component system BlaRI regulating the β‐lactamase BlaZ. BlaR binds extracellular β‐lactams, activating an intracellular peptidase domain which cleaves BlaI to derepress blaZ. Mycobacterium tuberculosis (Mtb) encodes homologs of BlaRI (which we will denote as BlaIR to reflect the inverted gene order in mycobacteria) that regulate not only the Mtb β‐lactamase, blaC, but also additional genes related to respiration. We identified orthologs of blaIRMtb in Mab and hypothesized that they regulate blaMab. Surprisingly, neither deletion of blaIRMab nor overexpression of only blaIMab altered blaMab expression or β‐lactam susceptibility. However, BlaIMab did bind to conserved motifs upstream of several Mab genes involved in respiration, yielding a putative regulon that partially overlapped with BlaIMtb. Prompted by evidence that respiration inhibitors including clofazimine induce the BlaI regulon in Mtb, we found that clofazimine triggers induction of blaIRMab and its downstream regulon. Highlighting an important role for BlaIRMab in adapting to disruptions in energy metabolism, constitutive repression of the BlaIMab regulon rendered Mab highly susceptible to clofazimine. In addition to our unexpected findings that BlaIRMab does not regulate β−lactam resistance, this study highlights the novel role of mycobacterial BlaRI‐type regulators in regulating electron transport and respiration. [ABSTRACT FROM AUTHOR]

Interoception, which refers to the perception of body's internal state, is implicated in emotional processes and psychopathological disorders. Over the last decades, different tools have been developed to measure interoceptive accuracy, or the ability to accurately perceive physiological signals. Most of these tools have focused on cardiac interoception, but respiratory interoception has been less investigated due to the more complex and less portable equipment required. In this study, we suggest a new duration discrimination respiratory (DDR) task that does not require complex equipment. Using an adaptive staircase procedure, this task aims to determine an individual's ability to detect exhalation longer than their resting reference duration. One hundred and twenty‐three healthy subjects completed the DDR task, an interoceptive task of heart rate discrimination, and filled out questionnaires on interoceptive awareness (Multidimensional Assessment of Interoceptive Awareness), alexithymia (Toronto Alexithymia Scale [TAS]), affects (Positive and Negative Affect Scale [PANAS]), and anamnestic. Results demonstrated a good internal consistency (Cronbach's alpha =.93) of the DDR task. On average, subjects needed 99.22% (SD = 36.38) of their reference exhalation time in addition to reference exhalation to detect a prolonged exhalation. Higher self‐reported fitness levels, not counting during the DDR task and lower difficulty in describing feelings (TAS subscale), predicted higher respiratory discrimination duration. In conclusion, this study demonstrates the utility of the DDR task as a valid measure of interoception. Growing interest in interoception highlights the need for reliable measures. Respiratory interoception is understudied compared to cardiac interoception. Non‐portable equipment for respiratory measures is limiting clinical research. Our task provides a portable and ecological measure of respiratory interoception. [ABSTRACT FROM AUTHOR]

Several studies suggest that breathing entrains neural oscillations and thereby improves visual detection and memory performance during nasal inhalation. However, the evidence for this association is mixed, with some studies finding no, minor, or opposite effects. Here, we tested whether nasal breathing phase influences memory of repeated images presented in a rapid serial visual presentation (RSVP) task. The RSVP task is ideal for studying the effects of respiratory‐entrained oscillations on visual memory because it engages critical aspects of sensory encoding that depend on oscillatory activity, such as fast processing of natural images, repetition detection, memory encoding, and retrieval. It also enables the presentation of a large number of stimuli during each phase of the breathing cycle. In two separate experiments (n = 72 and n = 142, respectively) where participants were explicitly asked to breathe through their nose, we found that nasal breathing phase at target presentation did not significantly affect memory performance. An exploratory analysis in the first experiment suggested a potential benefit for targets appearing approximately 1 s after inhalation. However, this finding was not replicated in the pre‐registered second experiment with a larger sample. Thus, in two large sample experiments, we found no measurable impact of breathing phase on memory performance in the RSVP task. These results suggest that the natural breathing cycle does not have a significant impact on memory for repeated images and raise doubts about the idea that visual memory is broadly affected by the breathing phase. Using a task that engages oscillatory activity‐dependent visual memory (fast processing of natural images), we find that the natural breathing cycle does not have a significant impact on recognition memory for repeated images. Our results question the notion that visual memory is broadly affected by breathing phase. [ABSTRACT FROM AUTHOR]

Thermal videos provide a privacy-preserving yet information-rich data source for remote health monitoring, especially for respiration rate (RR) estimation. This paper introduces an end-to-end deep learning approach to RR measurement using thermal video data. A detection transformer (DeTr) first finds the subject's facial region of interest in each thermal frame. A respiratory signal is estimated from a dynamically cropped thermal video using 3D convolutional neural networks and bi-directional long short-term memory stages. To account for the expected phase shift between the respiration measured using a respiratory effort belt vs. a facial video, a novel loss function based on negative maximum cross-correlation and absolute frequency peak difference was introduced. Thermal recordings from 22 subjects, with simultaneous gold standard respiratory effort measurements, were studied while sitting or standing, both with and without a face mask. The RR estimation results showed that our proposed method outperformed existing models, achieving an error of only 1.6 breaths per minute across the four conditions. The proposed method sets a new State-of-the-Art for RR estimation accuracy, while still permitting real-time RR estimation. [ABSTRACT FROM AUTHOR]

Objective: Contactless monitoring of instantaneous heart rate and respiration rate has a significant clinical relevance. This work aims to use Speckle Vibrometry (i.e., based on the secondary laser speckle effect) to contactlessly measure these two vital signs in an intensive care unit. Methods: In this work, we propose an algorithm for the estimation of instantaneous heart rate and respiration rate from mechanically ventilated patients. The algorithm uses multiple regions, principal component analysis, and dominant angle analysis. A semi-automated peak detection method is implemented to precisely label the aortic valve opening peak within the cardiac waveform. Results: Compared with electrocardiography, the present work achieves limits of agreement of [−2.19, 1.73] beats per minute of instantaneous heart rate. The measurement spot is on the chest covered with two to three layers of duvet blankets. Compared with the airway flow signal measured by the mechanical ventilator, the present work achieves limits of agreement of [−0.68, 0.46] respirations per minute of instantaneous respiration rate. Conclusions: These results showcased Speckle Vibrometry's potential in vital sign monitoring in a clinical setting. Significance: This is the first human clinical study for Speckle Vibrometry. [ABSTRACT FROM AUTHOR]

The sternohyoid muscle depresses the hyoid bone, but it is unclear whether the muscle contributes to respiratory and swallowing mechanisms. This study aimed to clarify whether the sternohyoid muscle participates in the respiration and swallowing reflex and how the activity is modulated in two conditions: with airway stenosis and with a fixed sternohyoid muscle length. Electromyographic activity in the sternohyoid, digastric, thyrohyoid, and diaphragm muscles was recorded in anesthetized rats. The sternohyoid muscle activity was observed in the inspiratory phase and during swallowing, and was well coordinated with digastric and thyrohyoid muscle activity. With airway stenosis, the respiratory activity per respiratory cycle was facilitated in all assessed muscles but the facilitation of activity per second occurred only in the digastric, thyrohyoid, and sternohyoid muscles. With airway stenosis, the swallowing activity was facilitated only in the digastric muscle but not in the thyrohyoid and sternohyoid muscles. Swallowing activity was not observed in the sternohyoid muscle in the condition with the sternohyoid muscle length fixed, although increased inspiratory activity remained. The current results suggest that 1) the sternohyoid muscle is slightly activated in the inspiratory phase, 2) the effect of airway stenosis on respiratory function may differ between the upper airway muscles and diaphragm, and 3) swallowing activity in the sternohyoid muscle is not dominantly controlled by the swallowing central pattern generator but instead occurs as a myotatic reflex. NEW & NOTEWORTHY: We found that the sternohyoid muscle was activated in the inspiratory phase. However, increased airway resistance had different effects on the extrathoracic muscles than on the diaphragm. The swallowing activity of the sternohyoid disappeared when the muscle length was fixed. These findings suggest that the sternohyoid muscle may be activated not by the swallowing central pattern generator but as a myotatic reflex. [ABSTRACT FROM AUTHOR]

Transient receptor potential ankyrin 1 (TRPA1), a member of the TRP superfamily of cation channels, is broadly expressed in sensory neural pathways, including the trigeminal neurons innervating the nasal cavity and vagal neurons innervating the trachea and the lung. TRPA1 acts as a detector of various irritant chemicals as well as hypoxia and hyperoxia. For the past 15 years, we have characterised its role in respiratory and behavioural modulation in vivo using Trpa1 knockout (KO) mice and wild‐type (WT) littermates. Trpa1 KO mice failed to detect, wake up from sleeping, and escape from formalin vapour and a mild hypoxic (15% O2) environment. Respiratory augmentation induced by mild hypoxia was absent in either Trpa1 KO mice or WT mice treated with a TRPA1 antagonist. Irritant gas introduced into the nasal cavity inhibited respiratory responses in WT mice but not in the KO mice. The effect of TRPA1 on the olfactory system seemed minimal because olfactory bulbectomized WT mice reacted similarly to the intact mice. Immunohistological analyses using a cellar activation marker, the phosphorylated form of extracellular signal‐regulated kinase, confirmed activation of trigeminal neurons in WT mice but not in Trpa1 KO mice in response to irritant chemicals and mild hypoxia. These data collectively show that TRPA1 is necessary for multiple chemical‐induced protective responses in respiration and behaviour. We propose that TRPA1 channels in the airway may play a sentinel role for environmental threats and prevent incoming damage. [ABSTRACT FROM AUTHOR]

Fatigue cracks, especially at their initial stage, can lead to a repetitive crack open-close breathing-like phenomenon in the vibration response of structural elements. As such, regularities, bi-linearity, or perturbations in the vibration response can arise. Entropy can be used to quantify the irregularity or bi-linearity in these responses since there is an apparent variation of entropy values on the two sides of a breathing crack. Here, we present a new breathing crack localisation method based on a spatially distributed entropy approach coupled with the empirical mode decomposition technique. To enhance the robustness, a pre-selection mechanism is proposed to select the most suitable entropy method. The proposed method is then employed to localise the breathing crack in a beam in a laboratory setup. It is concluded that the proposed approach can be effectively used for breathing crack localisation in a structural element. [ABSTRACT FROM AUTHOR]

Cold plasma (CP) is a novel environmental‐friendly preservation technology that causes minimal damage to fruits. The flavor and quality of winter jujubes have decreased with the extended storage time. Currently, the research on the use of CP on winter jujubes (Ziziphus jujuba Mill. 'Dongzao') mainly focuses on the effect of the treatment on storage quality. There is limited research on the effect of CP treatment on the flavor of winter jujubes. This study used different CP (80 kV) treatment durations (0, 5, and 10 min) to treat winter jujubes. The appropriate treatment time was selected by observing the changes in color, respiratory intensity, soluble sugar content, total acid content, and vitamin C (VC) content of winter jujubes. Amino acid analyzer and headspace solid‐phase microextraction in combination with gas chromatography coupled with mass spectrometric detection were used to analyze the effect of CP treatment on the flavor compounds of winter jujubes. The results showed that the 5‐min CP treatment could significantly slow down the red coloration of winter jujube while maintaining high soluble sugar, total acid, and VC content. At the respiration peak, the respiratory intensity of the 5‐min CP treatment group was 0.74 mg CO2·kg−1·h−1 lower than that of the control group (p < 0.05). CP treatment slowed down the decrease in the content of amino acids and volatile organic compounds (such as 2‐methyl‐4‐pentenal, 2‐hexenal, and 3‐hexenal) in winter jujubes. This study will provide basic data for applying CP preservation technology in postharvest winter jujubes. [ABSTRACT FROM AUTHOR]