Acute respiratory distress syndrome(ARDS)is a severe clinical condition characterized by acute respiratory failure due to widespread pulmonary inflammation and edema.The incidence of ARDS among intensive care unit(ICU...Acute respiratory distress syndrome(ARDS)is a severe clinical condition characterized by acute respiratory failure due to widespread pulmonary inflammation and edema.The incidence of ARDS among intensive care unit(ICU)patients is approximately 10%,with mortality rates ranging from 35%to 45%and exceeding 50%in severe cases.[1]Identifying and controlling risk factors for ARDS is critical for early prevention.Smoking remains a significant global public health issue,affecting one-third of adults and 40%of children through exposure to secondhand smoke.[2]In an animal study,cigarette smoke impaired lung endothelial barrier function through oxidative stress and exacerbated lipopolysaccharide-induced increases in vascular permeability in vivo.This finding is consistent with the pathological changes observed in ARDS.[3]Although many observational studies have suggested a potential link between smoking and ARDS,the causal relationship remains unclear.This study uses Mendelian randomization(MR)to explore whether smoking behavior causally influences ARDS and investigates the mechanisms by which smoking may contribute to ARDS development through transcriptomic analysis of the Gene Expression Omnibus(GEO)database.展开更多
Purpose:This study aimed to determine the nurses’profile characteristics that are associated with moral distress among nurses in selected government hospitals in Shangdong,China.Methods:This is a descriptive-correlat...Purpose:This study aimed to determine the nurses’profile characteristics that are associated with moral distress among nurses in selected government hospitals in Shangdong,China.Methods:This is a descriptive-correlational study.A total of 185 clinical registered nurses who met the eligibility criteria from different departments in two tertiary governmental hospitals in Jinan city were purposively selected to participate in this study.The instruments included the general demographic characteristics and Chinese version of Moral Distress Scale-Revised(MDS-R).Correlation technique,specifically Spearman’s rho,was utilized to determine the significant correlation between the selected nurse’s characteristics and moral distress.Ethical considerations were given by the Far Eastern University ethics review committee(FEU-ERC Code:2020-2021-079).Results:The number of patients nurses handled per shift(rs=0.650,p=0.032)and the type of patients that nurses handled(rs=0.718,p=0.020)are the nurses’profile factors that are significantly correlated with nurses’moral distress(p-value<0.05).As there is an increase in the number of patients handled every shift and the patients are becoming unstable,requiring complex care,the frequency and intensity of moral distress increase as well.Conclusion:The nurses’moral distress was registered at a low level in this study.Characteristics related to patients,such as the number and type assigned to nurses,are correlated to moral distress.The main source of the high frequency and intensity of moral distress among nurses is“futile care”and“false hope”.Educational learning program is recommended to manage and alleviate the moral distress of nurses.展开更多
Variation in the vocal behavior of nonhuman vertebrates includes graded transitions and more dramatic changes.Wapiti males produce a reproductive bugle that has a fundamental frequency that surpasses 2,000 Hz with evi...Variation in the vocal behavior of nonhuman vertebrates includes graded transitions and more dramatic changes.Wapiti males produce a reproductive bugle that has a fundamental frequency that surpasses 2,000 Hz with evidence of biphonation and other nonlinear phenomena.Here,we analyze the acoustic structure of captive wapiti vocalizations to compare the male bugle with 3 categories of distress vocalizations:neonate distress(capture)calls,calf isolation calls,and adult female isolation calls.These 4 high-arousal call categories serve a common general function in recruiting conspecifics but occur in different behavioral contexts(capture,isolation,reproduction).Our goal was to distinguish characteristics that vary in graded steps that may correspond to an animal’s age or size from characteristics that are unique to the bugle.Characteristics of the high and loud fundamental(G0)varied in an age/size-graded manner with a decrease in minimum G0,an increase in the maximum and range of G0,with no evidence of sex differences.The nonlinear phenomena of deterministic chaos,biphonation,and frequency jumps were present in all 4 call categories and became more common from the distress vocalizations of neonates to calves to adult females to the male bugle.Two temporal characteristics sharply distinguished the bugle from the 3 categories of distress vocalizations:these included a prolonged call duration and a maximum G0 that occurred much later in the call for the bugle than for distress vocalizations.Our results suggest that distress vocalizations of different age groups and the reproductive bugle of wapiti share a high G0,with age/size-graded changes in G0 and nonlinear phenomena,but differ sharply in temporal characteristics.展开更多
BACKGROUND Frailty has become a significant public health issue.The recent increase in the number of frail older adults has led to increased attention being paid to psycho-logical care services in communities.The soci...BACKGROUND Frailty has become a significant public health issue.The recent increase in the number of frail older adults has led to increased attention being paid to psycho-logical care services in communities.The social isolation of pre-frail older adults can impact their psychological distress.AIM To explore the mediating effect of health literacy between social isolation and psychological distress among communitydwelling older adults with pre-frailty.METHODS This descriptive cross-sectional study was conducted with 254 pre-frail older individuals aged 60 years and over.Social isolation,health literacy,and psycholo-gical distress were comprehensively measured using the Lubben Social Network Scale-6,12-item Short-Form Health Literacy Questionnaire,and the Kessler Psy-chological Distress Scale-10.Data were evaluated using the SPSS 27.0 package program and the PROCESS macro tool.Descriptive statistical analyses,correlation analyses,and bootstrap mediation tests were used to assess associations between the variables.RESULTS The results showed that social isolation had an effect on health literacy among pre-frail older adults(β=0.240,P<0.001),social isolation impact on psycho-logical distress pre-frail older adults(β=-0.415,P<0.001);health literacy was identified effect on psychological distress among pre-frail older persons(β=-0.307,P<0.001).Health literacy partially mediated the relationship between social isolation and psychological distress among community-dwelling older adults with pre-frailty,with a mediation effect of-0.074,accounting for 17.83%of the total effect.展开更多
Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major...Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major cause of morbidity and mortality in pediatrics. The aim of our study was to investigate the epidemiological, clinical and therapeutic aspects of respiratory distress in children aged between 1 month and 15 years seen in the emergency department of the Bangui paediatric university hospital. Methodology: This was a 3-month descriptive cross-sectional study, from January 1 to March 31, 2023. All children aged 1 month to less than 15 years presenting with respiratory distress were included. Results: A total of 3021 children were admitted to the emergency medical services of Bangui’s pediatric university hospital. Of these, 164 were included in the study. The predominance was male, with a sex ratio of 1.09. The 0 - 2 age group was the most represented, with 67 patients (42.85%). The majority of patients came from Bangui, accounting for 146 (89.02%) of cases. Respiratory difficulty (59.15%), characterized by dyspnea and cough, associated with fever, vomiting, physical asthenia and diarrhea, were the main reasons for consultation. The main pathologies noted were respiratory 92 (56.10%), followed by cardiac pathologies 21 (12.8%). Antibiotic administration (76.82%) was the most common therapeutic procedure used in the management of respiratory distress. Conclusion: Respiratory distress remains an important cause of infant mortality in our context, with major management problems.展开更多
Background:Acute respiratory distress syndrome(ARDS)is the major therapeutic dilemma associated with significant inflammation and severe pulmonary dysfunction.Liriodendrin is a bioactive compound extract from traditio...Background:Acute respiratory distress syndrome(ARDS)is the major therapeutic dilemma associated with significant inflammation and severe pulmonary dysfunction.Liriodendrin is a bioactive compound extract from traditional Chinesemedicine,historically utilized formodulating inflammatory responses and alleviating symptoms in multiple diseasemodels.Methods:At present,BALB/c mice to explore the effects of liriodendrin on lipopolysaccharide(LPS)-induced ARDS.Before LPS was administered,the mice were treated with either liriodendrin or dexamethasone.Leukocyte infiltration,lung edema,and alveolar-capillary barrier integrity were evaluated in the bronchoalveolar lavage fluid(BALF)and pulmonary parenchyma.The expression of adhesion molecules and proinflammatory cytokines in BALF was evaluated by enzyme-linked immunosorbent assay.Western blotting assay facilitated the analysis of the expression or phosphorylation of inducible nitric oxide synthase(iNOS),cyclooxygenase-2(COX-2),NOD-like receptor family pyrin domain-containing 3(NLRP3),apoptosis-associated speck-like protein containing a CARD(ASC),cleaved caspase-1(CL-csapase-1),nuclear factor kappa-light-chain-enhancer of activated B cells(NF-κB),inhibitor of kappa B(IκB),mitogen-activated protein kinase(MAPK),and protein kinase B(Akt)in the lungs.In addition,the anti-inflammatory effects of liriodendrin were evaluated in LPS-stimulated RAW264.7 macrophages.Before LPS was administered,the RAW264.7 macrophages were treated with either liriodendrin or dexamethasone.Nitric Oxide(NO)production was measured using the Griess reaction assay,while ELISA assessed IL-1β,IL-6,and TNF-αlevels.Western blot analysis evaluated NF-κB phosphorylation and the expression of NLRP3,ASC,and CLcaspase-1.Results:These outcomes revealed that liriodendrin intervention markedly ameliorated the pathological features of LPS-induced ARDS,including leukocyte infiltration,lung edema,and alveolar-capillary barrier disruption.Liriodendrin also reduced the LPS-induced secretion of intercellular adhesion molecule-1(ICAM-1)and vascular cell adhesionmolecule-1(VCAM-1),expression of iNOS and COX2,and production of proinflammatory cytokines.Finally,we further discovered that the concentration trend of liriodendron amelioration ofARDSwas similar to those ofNLRP3 formation,NF-κB pathway activation,and p38 MAPK,c-Jun N-terminal kinase(JNK),and Akt phosphorylation but not to that of extracellular signal-regulated kinase(ERK)phosphorylation.Liriodendrin inhibited LPS-induced inflammatory responses in RAW264.7 macrophages.It markedly reduced NO production,propro-inflammatorytokines,NF-κB phosphorylation,and NLRP3 formation.Conclusions:In summary,liriodendrin effectively ameliorated the pathological features of LPS-induced ARDS inmice,demonstrating significant anti-inflammatory properties attributed to NLRP3 formation through NF-κB pathway activation by p38MAPK,JNK,and Akt phosphorylation.In LPS-treated RAW264.7 macrophages,liriodendrin reduced NO production,pro-inflammatory cytokines,and NLRP3 formation,suggesting its potential as an agent for ARDS and relative inflammation.展开更多
Objectives This study aimed to develop and preliminarily assess the quality of a Mindfulness Breast Care(MBC)App to reduce body image distress and stigma among breast cancer survivors(BCSs).Methods The development pro...Objectives This study aimed to develop and preliminarily assess the quality of a Mindfulness Breast Care(MBC)App to reduce body image distress and stigma among breast cancer survivors(BCSs).Methods The development process of the MBC App involved:1)establishing a research group;2)determining of the content of the MBC App based on Mindfulness-Based Cognitive Therapy and 3)technical exploitation and maintenance.A mixed-methods study was conducted.We selected ten BCSs by a convenience sampling method.After using the APP for three months,five assessed the quality using the Mobile App Rating Scale:User Version(uMARS)and another five were interviewed for process evaluation.Results The MBC App was developed with three modules:1)Library to provide health education information on body image,stigma,mindfulness,recovery and etc;2)Mindfulness Yoga to offer 12 Hatha yoga videos for daily practice;and 3)Mindfulness Practices to have 12 sessions of mindfulness videoconferences.Based on the uMARS data,the MBC App received high ratings for functionality(4.10±0.34),aesthetics(3.93±0.55),information quality(4.10±0.72),and perceived impact(4.03±0.96),as well as moderate ratings for engagement(3.72±0.94)and subjective quality(3.87±0.77).Participants indicated that the MBC App provided reliable knowledge,information,and emotional support.Recommendations from participants included categorizing knowledge in the Library Module,recording videoconferences of mindfulness practice,and adding discussion sessions in the videoconference.Afterward,we optimized the MBC App to enhance the user experience accordingly.Conclusions The MBC App offers online mindfulness interventions specifically for BCSs in China.The preliminary quality assessment indicates that the MBC App may be a promising tool for delivering mindfulness interventions to BCSs.展开更多
Thyroid cancer is a common endocrine malignancy with a rising incidence.Pa-tients often suffer from mental pain due to concerns about recurrence,treatment-related side-effect,and body image changes.Demographic factors...Thyroid cancer is a common endocrine malignancy with a rising incidence.Pa-tients often suffer from mental pain due to concerns about recurrence,treatment-related side-effect,and body image changes.Demographic factors like age,gender,physiological factors such as somatic symptoms and disease stage,co-gnitive-regulatory factors including negative and positive thinking,and social factors like work,economy,education level,and social support all influence their mental state.Existing interventions,including nursing,psychological,and tra-ditional Chinese medicine-based methods,have some benefits but face limitations like short-term effectiveness and lack of standardization.Future research should focus on creating better-defined,long-term,and widely applicable intervention programs and explore positive psychology-based approaches to improve patients'mental well-being and quality of life.展开更多
BACKGROUND Diabetes distress(DD),an emotional problem arising from the challenges of living with diabetes and the relentless burden of daily self-management,is common among patients with type 2 diabetes(T2D).South Asi...BACKGROUND Diabetes distress(DD),an emotional problem arising from the challenges of living with diabetes and the relentless burden of daily self-management,is common among patients with type 2 diabetes(T2D).South Asia has a high T2D burden,and many studies have reported varying prevalence rates of DD in this area.AIM To estimate the pooled prevalence of DD among patients with T2D in South Asia,as it is crucial for developing effective therapeutic strategies.METHODS This systematic review and meta-analysis included cross-sectional studies conducted in South Asian countries involving adults with T2D and reported the prevalence of DD.The studies were identified by searching multiple electronic databases and registries from the inception of each database to January 30,2025,using prespecified search terms.Four authors screened and extracted data independently.Meta-analyses were conducted using RStudio software with a random-effects model.The primary outcome was the pooled prevalence of DD.RESULTS Thirty-seven cross-sectional studies(28 from India,five from Bangladesh,and two each from Pakistan and Sri Lanka)with mostly high methodological quality involving 11500 subjects were included.The pooled prevalence of DD was 44%(95%confidence interval:35-53,I2=97.4%).The prevalence of DD was highest in Pakistan(85%),followed by India and Bangladesh(42%each),and Sri Lanka(25%).Emotional burden was the most prevalent form of DD(60%),followed by treatment regimen-related distress(51%),interpersonal distress(31%),and physician-related distress(17%).Meta-regression analysis revealed no significant associations between the prevalence of DD and publication year,sample size,proportion of females,age,duration of diabetes,insulin usage,glycated hemoglobin levels,or diabetic complications.CONCLUSION South Asians with T2D seem to experience a relatively high burden of DD,and the emotional burden is the most common form of DD in this area.Larger studies utilizing unique tools and involving a broader participant base from the region would provide better epidemiological data for effectively planning high-quality diabetes care in South Asian countries.展开更多
Objective:To explore the correlation between disease uncertainty and psychological distress in hospitalized patients with primary liver cancer,providing a basis for clinical nursing interventions.Methods:A convenient ...Objective:To explore the correlation between disease uncertainty and psychological distress in hospitalized patients with primary liver cancer,providing a basis for clinical nursing interventions.Methods:A convenient sampling method was used to select 82 patients with primary liver cancer from a tertiary first-class hospital in Guangzhou from September 2023 to March 2024 as the research subjects.General information questionnaires,the Mishel Uncertainty in Illness Scale-Adult Version(MUIS-A),and the Kessler Psychological Distress Scale(K10)were used for investigation.Pearson correlation analysis and linear regression analysis were performed to explore the relationship between the two.Results:The total score of disease uncertainty in hospitalized patients with primary liver cancer was(99.20±8.79),and the total score of psychological distress was(22.87±9.46),both at a medium level.There was a positive correlation between disease uncertainty and psychological distress(r=0.360,P<0.01),and the ambiguity dimension had the strongest correlation with psychological distress(r=0.399,P<0.01).Regression analysis showed that the ambiguity dimension had a significant predictive effect on psychological distress(β=0.399,P<0.01).Conclusion:There is a close correlation between disease uncertainty and psychological distress in patients with primary liver cancer.In clinical nursing,it is necessary to pay special attention to patients’ambiguity regarding disease symptoms and prognosis.Targeted health education should be carried out to reduce their uncertainty,thereby improving their psychological state.展开更多
Autophagy plays a pivotal role in the development and resolution of sepsis-induced acute respiratory distress syndrome(S-ARDS),a critical condition characterized by severe inflammation,oxidative stress,apoptosis,and i...Autophagy plays a pivotal role in the development and resolution of sepsis-induced acute respiratory distress syndrome(S-ARDS),a critical condition characterized by severe inflammation,oxidative stress,apoptosis,and immune dysfunction.Traditional Chinese medicine(TCM)has emerged as a promising complementary therapy that modulates autophagy-related pathways.This review summarizes recent advances in understanding how TCM regulates autophagy to alleviate S-ARDS pathology.We highlight the mechanisms by which TCM influences autophagy to modulate inflammation,redox balance,programmed cell death,and immune responses.The integration of historical wisdom and modern molecular insights offers new therapeutic directions for S-ARDS treatment.展开更多
BACKGROUND Chronic kidney disease(CKD)is an incapacitating illness associated with distressing symptoms(DS)that have negative impact on patients’health-related quality of life(HRQOL).AIM To assess the severity of DS ...BACKGROUND Chronic kidney disease(CKD)is an incapacitating illness associated with distressing symptoms(DS)that have negative impact on patients’health-related quality of life(HRQOL).AIM To assess the severity of DS and their relationships with HRQOL among patients with CKD in Jordan.METHODS A descriptive cross-sectional design was used.A convenience sampling approach was used to recruit the participants.Patients with CKD(n=140)who visited the outpatient clinics in four hospitals in Amman between November 2021 and December 2021 were included.RESULTS The Edmonton Symptom Assessment System was used to measure the severity of the DS while the Short Form-36 tool was used to measure the HRQOL.Participants’mean age was 50.9(SD=15.14).Most of them were males(n=92,65.7%),married(n=95,67.9%),and unemployed(n=93,66.4%).The highest DS were tiredness(mean=4.68,SD=2.98)and worse well-being(mean=3.69,SD=2.43).The highest HRQOL mean score was for the bodily pain scale with a mean score of 68.50 out of 100(SD=32.02)followed by the emotional well-being scale with mean score of 67.60(SD=18.57).CONCLUSION Patients with CKD had suboptimal HRQOL,physically and mentally.They suffer from multiple DS that have a strong association with diminished HRQOL such as tiredness and depression.Therefore,healthcare providers should be equipped with the essential knowledge and skills to promote individualized strategies that focusing on symptom management.展开更多
Objective:To analyze the value of bedside cranial ultrasonography in the early diagnosis of neonatal brain tissue injury in intrauterine distress.Methods:128 neonates with suspected intrauterine distress admitted to t...Objective:To analyze the value of bedside cranial ultrasonography in the early diagnosis of neonatal brain tissue injury in intrauterine distress.Methods:128 neonates with suspected intrauterine distress admitted to the Yichang Central People’s Hospital from January 2023 to December 2024 were selected as study subjects based on the inclusion and exclusion criteria,and all subjects underwent bedside craniocerebral ultrasonography and MRI,and the results of MRI were used as the gold standard to divide the infants into the brain-injury group(n=31)and the no-brain-injury The children were divided into brain injury group(n=31)and no brain injury group(n=97),and the value of bedside cranial ultrasonography for early diagnosis of brain tissue injury in neonates with intrauterine distress was analyzed.Results:(1)Among the 128 cases of intrauterine distress neonates,31 cases were examined for abnormal signs,including 22 cases(70.97%)examined by bedside craniocerebral ultrasonography and 28 cases(90.32%)examined by MRI.(2)Bedside cranial ultrasound detected hypoxic-ischemic encephalopathy in 6 cases,accounting for 4.69%,ventricular widening in 2 cases,accounting for 1.56%,intracranial hemorrhage in 8 cases,accounting for 6.25%,periventricular softening of white matter in 5 cases,accounting for 3.91%,and cerebral edema in 1 case,accounting for 0.78%,while MRI detected hypoxic-ischemic encephalopathy in 9 cases,accounting for 7.03%.3 cases of ventricular widening,accounting for 2.34%,4 cases of intracranial hemorrhage,accounting for 3.13%,9 cases of periventricular-intraventricular white matter softening,accounting for 7.03%,and 3 cases of cerebral edema,accounting for 2.34%were examined.Among them,the detection rate of periventricular-intraventricular hemorrhage by bedside cranial ultrasound was significantly higher than that of MRI(P<0.05).Conclusion:The diagnostic value of bedside cranial ultrasound in periventricular-intraventricular hemorrhage is high,but the diagnostic value is not as good as that of MRI in other brain tissue injuries,and clinically appropriate examination protocols can be selected according to the specific types of craniocerebral injuries.展开更多
BACKGROUND Acute respiratory distress syndrome(ARDS)is a critical condition characterized by acute hypoxemia,non-cardiogenic pulmonary edema,and decreased lung compliance.The Berlin definition,updated in 2012,classifi...BACKGROUND Acute respiratory distress syndrome(ARDS)is a critical condition characterized by acute hypoxemia,non-cardiogenic pulmonary edema,and decreased lung compliance.The Berlin definition,updated in 2012,classifies ARDS severity based on the partial pressure of arterial oxygen/fractional inspired oxygen fraction ratio.Despite various treatment strategies,ARDS remains a significant public health concern with high mortality rates.AIM To evaluate the implications of driving pressure(DP)in ARDS management and its potential as a protective lung strategy.METHODS We conducted a systematic review using databases including EbscoHost,MEDLINE,CINAHL,PubMed,and Google Scholar.The search was limited to articles published between January 2015 and September 2024.Twenty-three peer-reviewed articles were selected based on inclusion criteria focusing on adult ARDS patients undergoing mechanical ventilation and DP strategies.The literature review was conducted and reported according to PRISMA 2020 guidelines.RESULTS DP,the difference between plateau pressure and positive end-expiratory pressure,is crucial in ARDS management.Studies indicate that lower DP levels are significantly associated with improved survival rates in ARDS patients.DP is a better predictor of mortality than tidal volume or positive end-expiratory pressure alone.Adjusting DP by optimizing lung compliance and minimizing overdistension and collapse can reduce ventilator-induced lung injury.CONCLUSION DP is a valuable parameter in ARDS management,offering a more precise measure of lung stress and strain than traditional metrics.Implementing DP as a threshold for safety can enhance protective ventilation strategies,po-tentially reducing mortality in ARDS patients.Further research is needed to refine DP measurement techniques and validate its clinical application in diverse patient populations.展开更多
Background:Theworld is nowexperiencing many crises and adversities of great impact that pose serious threats to both physical and mental health.Threats to mental health include major depressive disorder,which can be s...Background:Theworld is nowexperiencing many crises and adversities of great impact that pose serious threats to both physical and mental health.Threats to mental health include major depressive disorder,which can be severe and disabling.The current study aimed to identify the prevalence of one type of depressive disorder,reactive depression(RD),and its relationship to demographic and psychological variables.Methods:For this study,RD is defined as an abnormal emotional response to traumatic situations involving mood difficulties.This study created an online self-report reactive depression questionnaire consisting of 23 items distributed across three subscales:1)bad feelings and life attitudes,2)loss of hope and loneliness,and 3)feeling sad and loss of confidence.The questionnaire was administered to a volunteer sample of 362male and female Iraqi university students.Exploratory Factor Analysis(EFA),Confirmatory Factor Analysis(CFA),t-tests,and one-way Analysis of Variance(ANOVA)were used to investigate exploratory and confirmatory factor structures of the questionnaire.Results:Evidence of reactive depression was found in 18.2%of the students.Female students had significantly higher levels of reactive depression than males(female N=205,mean=85.00,SD=11.30;male N=157,mean=76.46,SD=11.51).The high levels of reactive depression identified in these students demonstrate the value of assessing reactive depression in university students.Conclusion:The study underscores that the loss of emotional and psychological security,particularly in the face of traumatic and permanent events such as the death of a loved one,may contribute to the onset and progression of depressive symptoms.Future research should explore the role of specific cultural factors and further validate the reactive depression questionnaire in broader populations.Additionally,there is a need for improvedmental health support in Iraqi universities,particularly for female students,who may face unique challenges.展开更多
Phencyclidine(PCP,known as angel dust) is a nonbarbiturate,non-narcotic intravenous(IV) anesthetic with potent analgesic effects.However,its medical use was discontinued because of postoperative agitation,disorientati...Phencyclidine(PCP,known as angel dust) is a nonbarbiturate,non-narcotic intravenous(IV) anesthetic with potent analgesic effects.However,its medical use was discontinued because of postoperative agitation,disorientation,psychosis,cardiotoxicity,and hallucinogenic effects.Consequently,the PCP began to be illicitly distributed.The use methods include snorting,inhalation,IV,and subcutaneous(SC) injection.[1-5] The characteristic toxidrome of PCP includes altered mental status,tachycardia,and nystagmus.At higher doses,patients may become comatose and develop sympathomimetic effects such as tachycardia,hypertension,hypersalivation,urinary retention,and bronchospasm.In cases of intoxication,the pupillary light reflex remains intact,although the pupil size may vary.[1,3-6] PCP has a direct cardiotoxic effect and may induce arrhythmias.[2] Hyperreflexia,muscle rigidity,choreiform movements and muscle fasciculations may occur.[2,4,6] PCP-induced acute respiratory distress syndrome(ARDS) and alveolar hemorrhage(AH) are rare but potentially life-threatening complications.The main causes of non-traumatic death in patients with PCP intoxication include cardiopulmonary arrest,intracranial hemorrhage and rhabdomyolysis.[2,3,5] This case report aims to emphasize the management and potential benefits of inhaled N-acetylcysteine(NAC) and tranexamic acid(TXA)for PCP-induced ARDS and AH.展开更多
Psychological distress detection plays a critical role in modern healthcare,especially in ambient environments where continuous monitoring is essential for timely intervention.Advances in sensor technology and artific...Psychological distress detection plays a critical role in modern healthcare,especially in ambient environments where continuous monitoring is essential for timely intervention.Advances in sensor technology and artificial intelligence(AI)have enabled the development of systems capable of mental health monitoring using multimodal data.However,existing models often struggle with contextual adaptation and real-time decision-making in dynamic settings.This paper addresses these challenges by proposing TRANS-HEALTH,a hybrid framework that integrates transformer-based inference with Belief-Desire-Intention(BDI)reasoning for real-time psychological distress detection.The framework utilizes a multimodal dataset containing EEG,GSR,heart rate,and activity data to predict distress while adapting to individual contexts.The methodology combines deep learning for robust pattern recognition and symbolic BDI reasoning to enable adaptive decision-making.The novelty of the approach lies in its seamless integration of transformermodelswith BDI reasoning,providing both high accuracy and contextual relevance in real time.Performance metrics such as accuracy,precision,recall,and F1-score are employed to evaluate the system’s performance.The results show that TRANS-HEALTH outperforms existing models,achieving 96.1% accuracy with 4.78 ms latency and significantly reducing false alerts,with an enhanced ability to engage users,making it suitable for deployment in wearable and remote healthcare environments.展开更多
Pulmonary fibrosis significantly contributes to the pathogenesis of acute respiratory distress syndrome(ARDS),markedly increasing patient mortality.Despite the established anti-fibrotic effects of mesenchymal stem cel...Pulmonary fibrosis significantly contributes to the pathogenesis of acute respiratory distress syndrome(ARDS),markedly increasing patient mortality.Despite the established anti-fibrotic effects of mesenchymal stem cells(MSCs),numerous challenges hinder their clinical application.A recent study demon-strated that microvesicles(MVs)from MSCs(MSC-MVs)could attenuate ARDS-related pulmonary fibrosis and enhance lung function via hepatocyte growth factor mRNA transcription.This discovery presents a promising strategy for managing ARDS-associated pulmonary fibrosis.This article initially examines the safety and efficacy of MSCs from both basic science and clinical perspectives,subsequently exploring the potential and obstacles of employing MSC-MVs as a novel therapeutic approach.Additionally,it provides perspectives on future research into the application of MSC-MVs in ARDS-associated pulmonary fi-brosis.展开更多
BACKGROUND A major cause of mortality in the coronavirus disease 2019(COVID-19)pandemic was acute respiratory distress syndrome(ARDS).Currently,moderate to severe ARDS induced by COVID-19(COVID ARDS)and other viral an...BACKGROUND A major cause of mortality in the coronavirus disease 2019(COVID-19)pandemic was acute respiratory distress syndrome(ARDS).Currently,moderate to severe ARDS induced by COVID-19(COVID ARDS)and other viral and non-viral etiologies are treated by traditional ARDS protocols that recommend 12-16 hours of prone position ventilation(PPV)with neuromuscular blocking agents(NMBA)and a trial of inhaled vasodilators(IVd)if oxygenation does not improve.However,debate on the efficacy of adjuncts to PPV and low tidal volume ventilation persists and evidence about the benefits of IVd/NMBA in COVID ARDS is sparse.In our multi-center retrospective review,we evaluated the impact of PPV,IVd,and NMBA on outcomes and lung mechanics in COVID ARDS patients with moderate to severe ARDS.AIM To evaluate the impact of PPV used alone or in combination with pulmonary IVd and/or NMBA in mechanically ventilated patients with moderate to severe ARDS during the COVID-19 pandemic.METHODS A retrospective study at two tertiary academic medical centers compared outcomes between COVID ARDS patients receiving PPV and patients in the supine position.PPV patients were divided based on concurrent use of ARDS adjunct therapies resulting in four subgroups:(1)PPV alone;(2)PPV and IVd;(3)PPV and NMBA;and(4)PPV,IVd,and NMBA.Primary outcomes were hospital and intensive care unit(ICU)length of stay(LOS),mortality,and venovenous extracorporeal membrane oxygenation(VV-ECMO)status.Secondary outcomes included changes in lung mechanics at 24-hour intervals for 7 days.RESULTS Total 114 patients were included in this study.Baseline respiratory parameters and Sequential Organ Failure Assessment scores were significantly worse in the PPV group.ICU LOS and LOS were significantly longer for patients who were proned,but no mortality benefit or difference in VV-ECMO status was found.Among the subgroups,no difference in primary outcomes were found.In the secondary analysis,PPV was associated with a significant improvement in arterial oxygen partial pressure(PaO_(2))/fractional inspired oxygen(FiO_(2))(P/F)ratio from day 1 to day 4(P<0.05)and higher driving pressures day 5 to day 7(P<0.05).The combination of PPV and IVd together resulted in improvements in P/F ratio from day 1 to day 7 and plateau pressure on day 4 and day 6(P<0.05).PPV with NMBA was not associated with improvements in any of the secondary outcomes.The use of all three rescue therapies together resulted in improvements in lung compliance on day 2(P<0.05)but no other improvements.CONCLUSION In mechanically ventilated patients diagnosed with moderate to severe COVID ARDS,PPV and PPV with the addition of IVd produced a significant and sustained increase in P/F ratio.The combination of PPV,IVd and NMBA improved compliance however this did not reach significance.Mortality and LOS did not improve with adjunct therapies.Further research is warranted to determine the efficacy of these therapies alone and in combination in the treatment of COVID ARDS.展开更多
BACKGROUND Accurate condition assessment is critical for improving the prognosis of neonatal respiratory distress syndrome(RDS),but current assessment methods for RDS pose a cumulative risk of harm to neonates.Thus,a ...BACKGROUND Accurate condition assessment is critical for improving the prognosis of neonatal respiratory distress syndrome(RDS),but current assessment methods for RDS pose a cumulative risk of harm to neonates.Thus,a less harmful method for assessing the health of neonates with RDS is needed.AIM To analyze the relationships between pulmonary ultrasonography and respiratory distress scores,oxygenation index,and chest X-ray grade of neonatal RDS to identify predictors of neonatal RDS severity.METHODS This retrospective study analyzed the medical information of 73 neonates with RDS admitted to the neonatal intensive care unit of Liupanshui Maternal and Child Care Service Center between April and December 2022.The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest Xray grade of each newborn before and after treatment were collected.Spearman correlation analysis was performed to determine the relationships among these values and neonatal RDS severity.RESULTS The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest X-ray RDS grade of the neonates were significantly lower after treatment than before treatment(P<0.05).Spearman correlation analysis showed that before and after treatment,the pulmonary ultrasonography score of neonates with RDS was positively correlated with the respiratory distress score,oxygenation index,and chest X-ray grade(ρ=0.429–0.859,P<0.05).Receiver operating characteristic curve analysis indicated that pulmonary ultrasonography screening effectively predicted the severity of neonatal RDS(area under the curve=0.805–1.000,P<0.05).CONCLUSION The pulmonary ultrasonography score was significantly associated with the neonatal RDS score,oxygenation index,and chest X-ray grade.The pulmonary ultrasonography score was an effective predictor of neonatal RDS severity.展开更多
基金funded by the Hunan Provincial Natural Science Foundation of China(2024JJ2038,2024JJ9161)the Central Government Guides Local Science and Technology Development Fund Projects(2024ZYC031)+4 种基金the Hunan Health High-Level Talent Project(R2023073)the National Key Clinical Specialty Scientific Research Project(Z2023114)the Young Doctor Foundation of Hunan Provincial People’s Hospital(BSJJ202209)the Key Cultivation Project of Hunan Provincial People’s Hospital(RS2022A06)the Clinical Research Center for Emergency and Critical Care in Hunan Province(2021SK4011).
文摘Acute respiratory distress syndrome(ARDS)is a severe clinical condition characterized by acute respiratory failure due to widespread pulmonary inflammation and edema.The incidence of ARDS among intensive care unit(ICU)patients is approximately 10%,with mortality rates ranging from 35%to 45%and exceeding 50%in severe cases.[1]Identifying and controlling risk factors for ARDS is critical for early prevention.Smoking remains a significant global public health issue,affecting one-third of adults and 40%of children through exposure to secondhand smoke.[2]In an animal study,cigarette smoke impaired lung endothelial barrier function through oxidative stress and exacerbated lipopolysaccharide-induced increases in vascular permeability in vivo.This finding is consistent with the pathological changes observed in ARDS.[3]Although many observational studies have suggested a potential link between smoking and ARDS,the causal relationship remains unclear.This study uses Mendelian randomization(MR)to explore whether smoking behavior causally influences ARDS and investigates the mechanisms by which smoking may contribute to ARDS development through transcriptomic analysis of the Gene Expression Omnibus(GEO)database.
文摘Purpose:This study aimed to determine the nurses’profile characteristics that are associated with moral distress among nurses in selected government hospitals in Shangdong,China.Methods:This is a descriptive-correlational study.A total of 185 clinical registered nurses who met the eligibility criteria from different departments in two tertiary governmental hospitals in Jinan city were purposively selected to participate in this study.The instruments included the general demographic characteristics and Chinese version of Moral Distress Scale-Revised(MDS-R).Correlation technique,specifically Spearman’s rho,was utilized to determine the significant correlation between the selected nurse’s characteristics and moral distress.Ethical considerations were given by the Far Eastern University ethics review committee(FEU-ERC Code:2020-2021-079).Results:The number of patients nurses handled per shift(rs=0.650,p=0.032)and the type of patients that nurses handled(rs=0.718,p=0.020)are the nurses’profile factors that are significantly correlated with nurses’moral distress(p-value<0.05).As there is an increase in the number of patients handled every shift and the patients are becoming unstable,requiring complex care,the frequency and intensity of moral distress increase as well.Conclusion:The nurses’moral distress was registered at a low level in this study.Characteristics related to patients,such as the number and type assigned to nurses,are correlated to moral distress.The main source of the high frequency and intensity of moral distress among nurses is“futile care”and“false hope”.Educational learning program is recommended to manage and alleviate the moral distress of nurses.
基金The University of Winnipeg and The University of Winnipeg Foundation contributed funding to this research.
文摘Variation in the vocal behavior of nonhuman vertebrates includes graded transitions and more dramatic changes.Wapiti males produce a reproductive bugle that has a fundamental frequency that surpasses 2,000 Hz with evidence of biphonation and other nonlinear phenomena.Here,we analyze the acoustic structure of captive wapiti vocalizations to compare the male bugle with 3 categories of distress vocalizations:neonate distress(capture)calls,calf isolation calls,and adult female isolation calls.These 4 high-arousal call categories serve a common general function in recruiting conspecifics but occur in different behavioral contexts(capture,isolation,reproduction).Our goal was to distinguish characteristics that vary in graded steps that may correspond to an animal’s age or size from characteristics that are unique to the bugle.Characteristics of the high and loud fundamental(G0)varied in an age/size-graded manner with a decrease in minimum G0,an increase in the maximum and range of G0,with no evidence of sex differences.The nonlinear phenomena of deterministic chaos,biphonation,and frequency jumps were present in all 4 call categories and became more common from the distress vocalizations of neonates to calves to adult females to the male bugle.Two temporal characteristics sharply distinguished the bugle from the 3 categories of distress vocalizations:these included a prolonged call duration and a maximum G0 that occurred much later in the call for the bugle than for distress vocalizations.Our results suggest that distress vocalizations of different age groups and the reproductive bugle of wapiti share a high G0,with age/size-graded changes in G0 and nonlinear phenomena,but differ sharply in temporal characteristics.
基金Supported by the Scientific Research Fund of Zhejiang Provincial Education Department,No.Y202351104and Huzhou Science and Technology Plan Project,No.2023GZ67。
文摘BACKGROUND Frailty has become a significant public health issue.The recent increase in the number of frail older adults has led to increased attention being paid to psycho-logical care services in communities.The social isolation of pre-frail older adults can impact their psychological distress.AIM To explore the mediating effect of health literacy between social isolation and psychological distress among communitydwelling older adults with pre-frailty.METHODS This descriptive cross-sectional study was conducted with 254 pre-frail older individuals aged 60 years and over.Social isolation,health literacy,and psycholo-gical distress were comprehensively measured using the Lubben Social Network Scale-6,12-item Short-Form Health Literacy Questionnaire,and the Kessler Psy-chological Distress Scale-10.Data were evaluated using the SPSS 27.0 package program and the PROCESS macro tool.Descriptive statistical analyses,correlation analyses,and bootstrap mediation tests were used to assess associations between the variables.RESULTS The results showed that social isolation had an effect on health literacy among pre-frail older adults(β=0.240,P<0.001),social isolation impact on psycho-logical distress pre-frail older adults(β=-0.415,P<0.001);health literacy was identified effect on psychological distress among pre-frail older persons(β=-0.307,P<0.001).Health literacy partially mediated the relationship between social isolation and psychological distress among community-dwelling older adults with pre-frailty,with a mediation effect of-0.074,accounting for 17.83%of the total effect.
文摘Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major cause of morbidity and mortality in pediatrics. The aim of our study was to investigate the epidemiological, clinical and therapeutic aspects of respiratory distress in children aged between 1 month and 15 years seen in the emergency department of the Bangui paediatric university hospital. Methodology: This was a 3-month descriptive cross-sectional study, from January 1 to March 31, 2023. All children aged 1 month to less than 15 years presenting with respiratory distress were included. Results: A total of 3021 children were admitted to the emergency medical services of Bangui’s pediatric university hospital. Of these, 164 were included in the study. The predominance was male, with a sex ratio of 1.09. The 0 - 2 age group was the most represented, with 67 patients (42.85%). The majority of patients came from Bangui, accounting for 146 (89.02%) of cases. Respiratory difficulty (59.15%), characterized by dyspnea and cough, associated with fever, vomiting, physical asthenia and diarrhea, were the main reasons for consultation. The main pathologies noted were respiratory 92 (56.10%), followed by cardiac pathologies 21 (12.8%). Antibiotic administration (76.82%) was the most common therapeutic procedure used in the management of respiratory distress. Conclusion: Respiratory distress remains an important cause of infant mortality in our context, with major management problems.
基金supported by Chung Shan Medical University and Changhua Christian Hospital(CSMU-CCH-111-08)supported by research grants from the Chung Shan Medical University Hospital,Taichung,Taiwan(CSH-2023-C-023)the National Science and Technology Council,Taiwan,for financially supporting this research under Contract Nos.NSTC 112-2320-B-040-017,NSTC112-2314-B-040-009,and NSTC 112-2320-B-040-011.
文摘Background:Acute respiratory distress syndrome(ARDS)is the major therapeutic dilemma associated with significant inflammation and severe pulmonary dysfunction.Liriodendrin is a bioactive compound extract from traditional Chinesemedicine,historically utilized formodulating inflammatory responses and alleviating symptoms in multiple diseasemodels.Methods:At present,BALB/c mice to explore the effects of liriodendrin on lipopolysaccharide(LPS)-induced ARDS.Before LPS was administered,the mice were treated with either liriodendrin or dexamethasone.Leukocyte infiltration,lung edema,and alveolar-capillary barrier integrity were evaluated in the bronchoalveolar lavage fluid(BALF)and pulmonary parenchyma.The expression of adhesion molecules and proinflammatory cytokines in BALF was evaluated by enzyme-linked immunosorbent assay.Western blotting assay facilitated the analysis of the expression or phosphorylation of inducible nitric oxide synthase(iNOS),cyclooxygenase-2(COX-2),NOD-like receptor family pyrin domain-containing 3(NLRP3),apoptosis-associated speck-like protein containing a CARD(ASC),cleaved caspase-1(CL-csapase-1),nuclear factor kappa-light-chain-enhancer of activated B cells(NF-κB),inhibitor of kappa B(IκB),mitogen-activated protein kinase(MAPK),and protein kinase B(Akt)in the lungs.In addition,the anti-inflammatory effects of liriodendrin were evaluated in LPS-stimulated RAW264.7 macrophages.Before LPS was administered,the RAW264.7 macrophages were treated with either liriodendrin or dexamethasone.Nitric Oxide(NO)production was measured using the Griess reaction assay,while ELISA assessed IL-1β,IL-6,and TNF-αlevels.Western blot analysis evaluated NF-κB phosphorylation and the expression of NLRP3,ASC,and CLcaspase-1.Results:These outcomes revealed that liriodendrin intervention markedly ameliorated the pathological features of LPS-induced ARDS,including leukocyte infiltration,lung edema,and alveolar-capillary barrier disruption.Liriodendrin also reduced the LPS-induced secretion of intercellular adhesion molecule-1(ICAM-1)and vascular cell adhesionmolecule-1(VCAM-1),expression of iNOS and COX2,and production of proinflammatory cytokines.Finally,we further discovered that the concentration trend of liriodendron amelioration ofARDSwas similar to those ofNLRP3 formation,NF-κB pathway activation,and p38 MAPK,c-Jun N-terminal kinase(JNK),and Akt phosphorylation but not to that of extracellular signal-regulated kinase(ERK)phosphorylation.Liriodendrin inhibited LPS-induced inflammatory responses in RAW264.7 macrophages.It markedly reduced NO production,propro-inflammatorytokines,NF-κB phosphorylation,and NLRP3 formation.Conclusions:In summary,liriodendrin effectively ameliorated the pathological features of LPS-induced ARDS inmice,demonstrating significant anti-inflammatory properties attributed to NLRP3 formation through NF-κB pathway activation by p38MAPK,JNK,and Akt phosphorylation.In LPS-treated RAW264.7 macrophages,liriodendrin reduced NO production,pro-inflammatory cytokines,and NLRP3 formation,suggesting its potential as an agent for ARDS and relative inflammation.
基金supported by the National Natural Science Foundation of China(No.71974162 and No.7231101009).
文摘Objectives This study aimed to develop and preliminarily assess the quality of a Mindfulness Breast Care(MBC)App to reduce body image distress and stigma among breast cancer survivors(BCSs).Methods The development process of the MBC App involved:1)establishing a research group;2)determining of the content of the MBC App based on Mindfulness-Based Cognitive Therapy and 3)technical exploitation and maintenance.A mixed-methods study was conducted.We selected ten BCSs by a convenience sampling method.After using the APP for three months,five assessed the quality using the Mobile App Rating Scale:User Version(uMARS)and another five were interviewed for process evaluation.Results The MBC App was developed with three modules:1)Library to provide health education information on body image,stigma,mindfulness,recovery and etc;2)Mindfulness Yoga to offer 12 Hatha yoga videos for daily practice;and 3)Mindfulness Practices to have 12 sessions of mindfulness videoconferences.Based on the uMARS data,the MBC App received high ratings for functionality(4.10±0.34),aesthetics(3.93±0.55),information quality(4.10±0.72),and perceived impact(4.03±0.96),as well as moderate ratings for engagement(3.72±0.94)and subjective quality(3.87±0.77).Participants indicated that the MBC App provided reliable knowledge,information,and emotional support.Recommendations from participants included categorizing knowledge in the Library Module,recording videoconferences of mindfulness practice,and adding discussion sessions in the videoconference.Afterward,we optimized the MBC App to enhance the user experience accordingly.Conclusions The MBC App offers online mindfulness interventions specifically for BCSs in China.The preliminary quality assessment indicates that the MBC App may be a promising tool for delivering mindfulness interventions to BCSs.
文摘Thyroid cancer is a common endocrine malignancy with a rising incidence.Pa-tients often suffer from mental pain due to concerns about recurrence,treatment-related side-effect,and body image changes.Demographic factors like age,gender,physiological factors such as somatic symptoms and disease stage,co-gnitive-regulatory factors including negative and positive thinking,and social factors like work,economy,education level,and social support all influence their mental state.Existing interventions,including nursing,psychological,and tra-ditional Chinese medicine-based methods,have some benefits but face limitations like short-term effectiveness and lack of standardization.Future research should focus on creating better-defined,long-term,and widely applicable intervention programs and explore positive psychology-based approaches to improve patients'mental well-being and quality of life.
文摘BACKGROUND Diabetes distress(DD),an emotional problem arising from the challenges of living with diabetes and the relentless burden of daily self-management,is common among patients with type 2 diabetes(T2D).South Asia has a high T2D burden,and many studies have reported varying prevalence rates of DD in this area.AIM To estimate the pooled prevalence of DD among patients with T2D in South Asia,as it is crucial for developing effective therapeutic strategies.METHODS This systematic review and meta-analysis included cross-sectional studies conducted in South Asian countries involving adults with T2D and reported the prevalence of DD.The studies were identified by searching multiple electronic databases and registries from the inception of each database to January 30,2025,using prespecified search terms.Four authors screened and extracted data independently.Meta-analyses were conducted using RStudio software with a random-effects model.The primary outcome was the pooled prevalence of DD.RESULTS Thirty-seven cross-sectional studies(28 from India,five from Bangladesh,and two each from Pakistan and Sri Lanka)with mostly high methodological quality involving 11500 subjects were included.The pooled prevalence of DD was 44%(95%confidence interval:35-53,I2=97.4%).The prevalence of DD was highest in Pakistan(85%),followed by India and Bangladesh(42%each),and Sri Lanka(25%).Emotional burden was the most prevalent form of DD(60%),followed by treatment regimen-related distress(51%),interpersonal distress(31%),and physician-related distress(17%).Meta-regression analysis revealed no significant associations between the prevalence of DD and publication year,sample size,proportion of females,age,duration of diabetes,insulin usage,glycated hemoglobin levels,or diabetic complications.CONCLUSION South Asians with T2D seem to experience a relatively high burden of DD,and the emotional burden is the most common form of DD in this area.Larger studies utilizing unique tools and involving a broader participant base from the region would provide better epidemiological data for effectively planning high-quality diabetes care in South Asian countries.
文摘Objective:To explore the correlation between disease uncertainty and psychological distress in hospitalized patients with primary liver cancer,providing a basis for clinical nursing interventions.Methods:A convenient sampling method was used to select 82 patients with primary liver cancer from a tertiary first-class hospital in Guangzhou from September 2023 to March 2024 as the research subjects.General information questionnaires,the Mishel Uncertainty in Illness Scale-Adult Version(MUIS-A),and the Kessler Psychological Distress Scale(K10)were used for investigation.Pearson correlation analysis and linear regression analysis were performed to explore the relationship between the two.Results:The total score of disease uncertainty in hospitalized patients with primary liver cancer was(99.20±8.79),and the total score of psychological distress was(22.87±9.46),both at a medium level.There was a positive correlation between disease uncertainty and psychological distress(r=0.360,P<0.01),and the ambiguity dimension had the strongest correlation with psychological distress(r=0.399,P<0.01).Regression analysis showed that the ambiguity dimension had a significant predictive effect on psychological distress(β=0.399,P<0.01).Conclusion:There is a close correlation between disease uncertainty and psychological distress in patients with primary liver cancer.In clinical nursing,it is necessary to pay special attention to patients’ambiguity regarding disease symptoms and prognosis.Targeted health education should be carried out to reduce their uncertainty,thereby improving their psychological state.
基金supported by the National Natural Science Foundation of China(82102311)Peking Union Medical Foundation-Rui E(Rui Yi)Emergency Medicine Research Special Fund(22222012001)+2 种基金Xuzhou Municipal Health Commission Medical Science and Technology Innovation Project(XWKYHT20240080)Xuzhou Medical University Affiliated Hospital Science and Technology Development Fund(XYFY202402)Translational Medicine Foundation from Jiangsu Society of Research Hospital(SYHKJ-XF-2025-22).
文摘Autophagy plays a pivotal role in the development and resolution of sepsis-induced acute respiratory distress syndrome(S-ARDS),a critical condition characterized by severe inflammation,oxidative stress,apoptosis,and immune dysfunction.Traditional Chinese medicine(TCM)has emerged as a promising complementary therapy that modulates autophagy-related pathways.This review summarizes recent advances in understanding how TCM regulates autophagy to alleviate S-ARDS pathology.We highlight the mechanisms by which TCM influences autophagy to modulate inflammation,redox balance,programmed cell death,and immune responses.The integration of historical wisdom and modern molecular insights offers new therapeutic directions for S-ARDS treatment.
文摘BACKGROUND Chronic kidney disease(CKD)is an incapacitating illness associated with distressing symptoms(DS)that have negative impact on patients’health-related quality of life(HRQOL).AIM To assess the severity of DS and their relationships with HRQOL among patients with CKD in Jordan.METHODS A descriptive cross-sectional design was used.A convenience sampling approach was used to recruit the participants.Patients with CKD(n=140)who visited the outpatient clinics in four hospitals in Amman between November 2021 and December 2021 were included.RESULTS The Edmonton Symptom Assessment System was used to measure the severity of the DS while the Short Form-36 tool was used to measure the HRQOL.Participants’mean age was 50.9(SD=15.14).Most of them were males(n=92,65.7%),married(n=95,67.9%),and unemployed(n=93,66.4%).The highest DS were tiredness(mean=4.68,SD=2.98)and worse well-being(mean=3.69,SD=2.43).The highest HRQOL mean score was for the bodily pain scale with a mean score of 68.50 out of 100(SD=32.02)followed by the emotional well-being scale with mean score of 67.60(SD=18.57).CONCLUSION Patients with CKD had suboptimal HRQOL,physically and mentally.They suffer from multiple DS that have a strong association with diminished HRQOL such as tiredness and depression.Therefore,healthcare providers should be equipped with the essential knowledge and skills to promote individualized strategies that focusing on symptom management.
文摘Objective:To analyze the value of bedside cranial ultrasonography in the early diagnosis of neonatal brain tissue injury in intrauterine distress.Methods:128 neonates with suspected intrauterine distress admitted to the Yichang Central People’s Hospital from January 2023 to December 2024 were selected as study subjects based on the inclusion and exclusion criteria,and all subjects underwent bedside craniocerebral ultrasonography and MRI,and the results of MRI were used as the gold standard to divide the infants into the brain-injury group(n=31)and the no-brain-injury The children were divided into brain injury group(n=31)and no brain injury group(n=97),and the value of bedside cranial ultrasonography for early diagnosis of brain tissue injury in neonates with intrauterine distress was analyzed.Results:(1)Among the 128 cases of intrauterine distress neonates,31 cases were examined for abnormal signs,including 22 cases(70.97%)examined by bedside craniocerebral ultrasonography and 28 cases(90.32%)examined by MRI.(2)Bedside cranial ultrasound detected hypoxic-ischemic encephalopathy in 6 cases,accounting for 4.69%,ventricular widening in 2 cases,accounting for 1.56%,intracranial hemorrhage in 8 cases,accounting for 6.25%,periventricular softening of white matter in 5 cases,accounting for 3.91%,and cerebral edema in 1 case,accounting for 0.78%,while MRI detected hypoxic-ischemic encephalopathy in 9 cases,accounting for 7.03%.3 cases of ventricular widening,accounting for 2.34%,4 cases of intracranial hemorrhage,accounting for 3.13%,9 cases of periventricular-intraventricular white matter softening,accounting for 7.03%,and 3 cases of cerebral edema,accounting for 2.34%were examined.Among them,the detection rate of periventricular-intraventricular hemorrhage by bedside cranial ultrasound was significantly higher than that of MRI(P<0.05).Conclusion:The diagnostic value of bedside cranial ultrasound in periventricular-intraventricular hemorrhage is high,but the diagnostic value is not as good as that of MRI in other brain tissue injuries,and clinically appropriate examination protocols can be selected according to the specific types of craniocerebral injuries.
文摘BACKGROUND Acute respiratory distress syndrome(ARDS)is a critical condition characterized by acute hypoxemia,non-cardiogenic pulmonary edema,and decreased lung compliance.The Berlin definition,updated in 2012,classifies ARDS severity based on the partial pressure of arterial oxygen/fractional inspired oxygen fraction ratio.Despite various treatment strategies,ARDS remains a significant public health concern with high mortality rates.AIM To evaluate the implications of driving pressure(DP)in ARDS management and its potential as a protective lung strategy.METHODS We conducted a systematic review using databases including EbscoHost,MEDLINE,CINAHL,PubMed,and Google Scholar.The search was limited to articles published between January 2015 and September 2024.Twenty-three peer-reviewed articles were selected based on inclusion criteria focusing on adult ARDS patients undergoing mechanical ventilation and DP strategies.The literature review was conducted and reported according to PRISMA 2020 guidelines.RESULTS DP,the difference between plateau pressure and positive end-expiratory pressure,is crucial in ARDS management.Studies indicate that lower DP levels are significantly associated with improved survival rates in ARDS patients.DP is a better predictor of mortality than tidal volume or positive end-expiratory pressure alone.Adjusting DP by optimizing lung compliance and minimizing overdistension and collapse can reduce ventilator-induced lung injury.CONCLUSION DP is a valuable parameter in ARDS management,offering a more precise measure of lung stress and strain than traditional metrics.Implementing DP as a threshold for safety can enhance protective ventilation strategies,po-tentially reducing mortality in ARDS patients.Further research is needed to refine DP measurement techniques and validate its clinical application in diverse patient populations.
文摘Background:Theworld is nowexperiencing many crises and adversities of great impact that pose serious threats to both physical and mental health.Threats to mental health include major depressive disorder,which can be severe and disabling.The current study aimed to identify the prevalence of one type of depressive disorder,reactive depression(RD),and its relationship to demographic and psychological variables.Methods:For this study,RD is defined as an abnormal emotional response to traumatic situations involving mood difficulties.This study created an online self-report reactive depression questionnaire consisting of 23 items distributed across three subscales:1)bad feelings and life attitudes,2)loss of hope and loneliness,and 3)feeling sad and loss of confidence.The questionnaire was administered to a volunteer sample of 362male and female Iraqi university students.Exploratory Factor Analysis(EFA),Confirmatory Factor Analysis(CFA),t-tests,and one-way Analysis of Variance(ANOVA)were used to investigate exploratory and confirmatory factor structures of the questionnaire.Results:Evidence of reactive depression was found in 18.2%of the students.Female students had significantly higher levels of reactive depression than males(female N=205,mean=85.00,SD=11.30;male N=157,mean=76.46,SD=11.51).The high levels of reactive depression identified in these students demonstrate the value of assessing reactive depression in university students.Conclusion:The study underscores that the loss of emotional and psychological security,particularly in the face of traumatic and permanent events such as the death of a loved one,may contribute to the onset and progression of depressive symptoms.Future research should explore the role of specific cultural factors and further validate the reactive depression questionnaire in broader populations.Additionally,there is a need for improvedmental health support in Iraqi universities,particularly for female students,who may face unique challenges.
文摘Phencyclidine(PCP,known as angel dust) is a nonbarbiturate,non-narcotic intravenous(IV) anesthetic with potent analgesic effects.However,its medical use was discontinued because of postoperative agitation,disorientation,psychosis,cardiotoxicity,and hallucinogenic effects.Consequently,the PCP began to be illicitly distributed.The use methods include snorting,inhalation,IV,and subcutaneous(SC) injection.[1-5] The characteristic toxidrome of PCP includes altered mental status,tachycardia,and nystagmus.At higher doses,patients may become comatose and develop sympathomimetic effects such as tachycardia,hypertension,hypersalivation,urinary retention,and bronchospasm.In cases of intoxication,the pupillary light reflex remains intact,although the pupil size may vary.[1,3-6] PCP has a direct cardiotoxic effect and may induce arrhythmias.[2] Hyperreflexia,muscle rigidity,choreiform movements and muscle fasciculations may occur.[2,4,6] PCP-induced acute respiratory distress syndrome(ARDS) and alveolar hemorrhage(AH) are rare but potentially life-threatening complications.The main causes of non-traumatic death in patients with PCP intoxication include cardiopulmonary arrest,intracranial hemorrhage and rhabdomyolysis.[2,3,5] This case report aims to emphasize the management and potential benefits of inhaled N-acetylcysteine(NAC) and tranexamic acid(TXA)for PCP-induced ARDS and AH.
基金funded by Princess Nourah bint Abdulrahman University Researchers Supporting Project number(PNURSP2025R435),Princess Nourah bint Abdulrahman University,Riyadh,Saudi Arabia.
文摘Psychological distress detection plays a critical role in modern healthcare,especially in ambient environments where continuous monitoring is essential for timely intervention.Advances in sensor technology and artificial intelligence(AI)have enabled the development of systems capable of mental health monitoring using multimodal data.However,existing models often struggle with contextual adaptation and real-time decision-making in dynamic settings.This paper addresses these challenges by proposing TRANS-HEALTH,a hybrid framework that integrates transformer-based inference with Belief-Desire-Intention(BDI)reasoning for real-time psychological distress detection.The framework utilizes a multimodal dataset containing EEG,GSR,heart rate,and activity data to predict distress while adapting to individual contexts.The methodology combines deep learning for robust pattern recognition and symbolic BDI reasoning to enable adaptive decision-making.The novelty of the approach lies in its seamless integration of transformermodelswith BDI reasoning,providing both high accuracy and contextual relevance in real time.Performance metrics such as accuracy,precision,recall,and F1-score are employed to evaluate the system’s performance.The results show that TRANS-HEALTH outperforms existing models,achieving 96.1% accuracy with 4.78 ms latency and significantly reducing false alerts,with an enhanced ability to engage users,making it suitable for deployment in wearable and remote healthcare environments.
文摘Pulmonary fibrosis significantly contributes to the pathogenesis of acute respiratory distress syndrome(ARDS),markedly increasing patient mortality.Despite the established anti-fibrotic effects of mesenchymal stem cells(MSCs),numerous challenges hinder their clinical application.A recent study demon-strated that microvesicles(MVs)from MSCs(MSC-MVs)could attenuate ARDS-related pulmonary fibrosis and enhance lung function via hepatocyte growth factor mRNA transcription.This discovery presents a promising strategy for managing ARDS-associated pulmonary fibrosis.This article initially examines the safety and efficacy of MSCs from both basic science and clinical perspectives,subsequently exploring the potential and obstacles of employing MSC-MVs as a novel therapeutic approach.Additionally,it provides perspectives on future research into the application of MSC-MVs in ARDS-associated pulmonary fi-brosis.
文摘BACKGROUND A major cause of mortality in the coronavirus disease 2019(COVID-19)pandemic was acute respiratory distress syndrome(ARDS).Currently,moderate to severe ARDS induced by COVID-19(COVID ARDS)and other viral and non-viral etiologies are treated by traditional ARDS protocols that recommend 12-16 hours of prone position ventilation(PPV)with neuromuscular blocking agents(NMBA)and a trial of inhaled vasodilators(IVd)if oxygenation does not improve.However,debate on the efficacy of adjuncts to PPV and low tidal volume ventilation persists and evidence about the benefits of IVd/NMBA in COVID ARDS is sparse.In our multi-center retrospective review,we evaluated the impact of PPV,IVd,and NMBA on outcomes and lung mechanics in COVID ARDS patients with moderate to severe ARDS.AIM To evaluate the impact of PPV used alone or in combination with pulmonary IVd and/or NMBA in mechanically ventilated patients with moderate to severe ARDS during the COVID-19 pandemic.METHODS A retrospective study at two tertiary academic medical centers compared outcomes between COVID ARDS patients receiving PPV and patients in the supine position.PPV patients were divided based on concurrent use of ARDS adjunct therapies resulting in four subgroups:(1)PPV alone;(2)PPV and IVd;(3)PPV and NMBA;and(4)PPV,IVd,and NMBA.Primary outcomes were hospital and intensive care unit(ICU)length of stay(LOS),mortality,and venovenous extracorporeal membrane oxygenation(VV-ECMO)status.Secondary outcomes included changes in lung mechanics at 24-hour intervals for 7 days.RESULTS Total 114 patients were included in this study.Baseline respiratory parameters and Sequential Organ Failure Assessment scores were significantly worse in the PPV group.ICU LOS and LOS were significantly longer for patients who were proned,but no mortality benefit or difference in VV-ECMO status was found.Among the subgroups,no difference in primary outcomes were found.In the secondary analysis,PPV was associated with a significant improvement in arterial oxygen partial pressure(PaO_(2))/fractional inspired oxygen(FiO_(2))(P/F)ratio from day 1 to day 4(P<0.05)and higher driving pressures day 5 to day 7(P<0.05).The combination of PPV and IVd together resulted in improvements in P/F ratio from day 1 to day 7 and plateau pressure on day 4 and day 6(P<0.05).PPV with NMBA was not associated with improvements in any of the secondary outcomes.The use of all three rescue therapies together resulted in improvements in lung compliance on day 2(P<0.05)but no other improvements.CONCLUSION In mechanically ventilated patients diagnosed with moderate to severe COVID ARDS,PPV and PPV with the addition of IVd produced a significant and sustained increase in P/F ratio.The combination of PPV,IVd and NMBA improved compliance however this did not reach significance.Mortality and LOS did not improve with adjunct therapies.Further research is warranted to determine the efficacy of these therapies alone and in combination in the treatment of COVID ARDS.
基金Guizhou Provincial Science and Technology Department,Technology Achievement Application and Industrialization Plan,Applied Fundamental Research,No.Qianke Synthetic Fruit[2022]004.
文摘BACKGROUND Accurate condition assessment is critical for improving the prognosis of neonatal respiratory distress syndrome(RDS),but current assessment methods for RDS pose a cumulative risk of harm to neonates.Thus,a less harmful method for assessing the health of neonates with RDS is needed.AIM To analyze the relationships between pulmonary ultrasonography and respiratory distress scores,oxygenation index,and chest X-ray grade of neonatal RDS to identify predictors of neonatal RDS severity.METHODS This retrospective study analyzed the medical information of 73 neonates with RDS admitted to the neonatal intensive care unit of Liupanshui Maternal and Child Care Service Center between April and December 2022.The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest Xray grade of each newborn before and after treatment were collected.Spearman correlation analysis was performed to determine the relationships among these values and neonatal RDS severity.RESULTS The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest X-ray RDS grade of the neonates were significantly lower after treatment than before treatment(P<0.05).Spearman correlation analysis showed that before and after treatment,the pulmonary ultrasonography score of neonates with RDS was positively correlated with the respiratory distress score,oxygenation index,and chest X-ray grade(ρ=0.429–0.859,P<0.05).Receiver operating characteristic curve analysis indicated that pulmonary ultrasonography screening effectively predicted the severity of neonatal RDS(area under the curve=0.805–1.000,P<0.05).CONCLUSION The pulmonary ultrasonography score was significantly associated with the neonatal RDS score,oxygenation index,and chest X-ray grade.The pulmonary ultrasonography score was an effective predictor of neonatal RDS severity.
