Search Results (1,027)

Nitrous oxide (N₂O), commonly known as laughing gas, is widely used for its anesthetic and analgesic properties in medical settings. However, its recreational abuse has escalated, leading to severe neurological complications including cognitive impairment, yet the underlying mechanisms remain poorly understood. In this study, male C57BL/6 J mice were exposed to either normal air inhalation or nitrous oxide inhalation for 28 days to evaluate the effects of repeated nitrous oxide exposure on cognitive function. We employed hippocampal transcriptome sequencing, real-time PCR, Western blotting, and non-targeted plasma metabolomics to explore potential regulatory mechanisms. Repeated nitrous oxide exposure impaired motor skills, learning, and cognitive abilities in mice. Integrative multi-omics analysis revealed that differentially expressed metabolites and genes synergistically disrupted energy metabolism through co-regulation of the TCA cycle, MAPK signaling pathway, and pyrimidine metabolism, ultimately leading to impaired cellular signaling, nucleic acid synthesis, and cognitive dysfunction. Our study provides novel multi-omics insights into the MAPK/ERK/CREB-mediated neurotoxicity and energy metabolism collapse induced by nitrous oxide as a recreational drug of abuse, offering new directions for clinical intervention. Full article

Patients with chronic kidney disease (CKD), particularly those receiving hemodialysis (HD), may be more vulnerable to exposure to micro- and nanoplastics (MNPs) and bisphenol A (BPA) because of impaired renal clearance and frequent contact to plastic-based medical devices. This study aimed to assess and compare the levels of blood MNPs and urinary BPA in HD patients, non-dialysis CKD patients, and healthy subjects with a focus on sex-related differences and the potential role of hemodialysis as an additional source of exposure. A cross-sectional human biomonitoring study was conducted. Blood and urine samples were collected to quantify BPA using gas chromatography–mass spectrometry (GC–MS) and MNPs using scanning electron microscopy coupled with an Energy-Dispersive X-ray Detector (SEM-EDX). Descriptive statistics included medians, interquartile ranges (IQRs), 95% confidence intervals, frequencies, and percentages. Blood MNP levels were higher in HD [9889 (4525–14,939) p/mL] and non-dialysis CKD patients [9234 (3354–15,429) p/mL] than in healthy subjects [5755 (2488–9042) p/mL]. Urinary MNP levels were also higher in non-dialysis CKD patients [1231 (0–8281) p/mL] than in healthy subjects [411 (0–1636) p/mL]. Urinary MNPs were smaller in non-dialysis CKD patients than in healthy subjects. In contrast, urinary BPA levels were lower in non-dialysis CKD patients [0.16 (0.12–0.16)] than in healthy subjects [0.98 (0.60–2.36)]. Sex-specific patterns were observed. Females had higher blood MNP levels than males among HD patients (median 9907 vs. 9063 p/mL) and healthy subjects (6627 vs. 4131 p/mL), whereas the opposite pattern was observed in non-dialysis CKD patients (10,083 vs. 7340 p/mL). Overall, these findings suggest an increased systemic burden of MNPs and altered BPA elimination in non-dialysis CKD and HD patients. The observed sex-specific patterns suggest that biological sex may contribute to differences in internal exposure within this vulnerable population. Full article

Healthcare services account for approximately 4–5% of global greenhouse gas emissions worldwide, and nearly 10% of emissions in the United States are primarily from general hospital operations, surgical and anesthetic care, and pharmaceutical and medical device supply chains. Healthcare services and operations also generate substantial plastic and chemical waste that pollute the environment and disproportionately affect vulnerable communities. Although global and national organizations have introduced decarbonization frameworks, adoption remains hindered by limited leadership engagement, competing institutional priorities, and insufficient regulatory accountability. This article synthesizes the published literature on the current landscape of healthcare sustainability, summarizes key policy frameworks, and identifies major barriers to implementation; these findings are then illustrated through sustainability initiatives at Stanford Medicine, a quaternary hospital system. These efforts are presented as implementation examples that other institutions may adapt to their own resources and contexts, to reduce emissions and ensure more sustainable healthcare delivery. Full article

Raman spectroscopy has emerged as a powerful tool for gas detection due to its label-free operation, molecular specificity, and multi-component analysis capabilities. However, its widespread application is hindered by limited sensitivity, particularly for trace gas analysis. To overcome this challenge, this study introduced an effective Raman spectroscopy detection system that synergistically combines a 532 nm high-power laser with a near-concentric multipass cell (MPC), enabling dual enhancement of both Raman excitation and signal collection. We simultaneously determined three critical performance metrics, including gas Raman signal intensity, signal-to-noise ratio (SNR), and limit of detection (LOD). Under the optimized experimental conditions, the CO₂ Raman signal reached an SNR of approximately 58 for laboratory air containing 916 ppm CO₂, corresponding to a concentration-equivalent detection limit of 48 ppm according to the 3σ criterion. Notably, the intensity of the generated Raman scattering signal is proportional to the average power. The intensity of Raman signals at different wave numbers increases at different rates with the increase in the average excitation power. The system achieves a remarkable LOD of 48 ppm for CO₂, representing an advancement over conventional Raman gas sensors. This work validates high-power near-concentric cavity-enhanced Raman spectroscopy as a reliable method for trace gas detection, with potential implications for multi-component gas analyzers in environmental monitoring, industrial safety, and medical diagnostics. Full article

Pediatric obstructive sleep apnea (OSA) is a common disorder associated with significant neurocognitive, behavioral, cardiovascular, and metabolic consequences. Although adenotonsillectomy remains first-line therapy for many children, residual OSA is common, particularly among those with obesity, craniofacial abnormalities, genetic syndromes, neuromuscular disease, or other forms of medical complexity. Continuous positive airway pressure (CPAP) is the standard non-surgical treatment; however, long-term effectiveness is frequently limited by poor tolerance and adherence. Heated high-flow nasal cannula (HFNC) therapy has emerged as a potential alternative for selected children with sleep-disordered breathing, particularly those who are unable to tolerate conventional positive airway pressure therapy. Unlike CPAP, HFNC delivers heated, humidified gas through an open nasal interface and may improve sleep-disordered breathing through a combination of flow-dependent positive airway pressure generation, dead-space washout, improved ventilatory efficiency, enhanced gas conditioning, and reductions in inspiratory resistance. However, the relative contribution of these mechanisms during sleep remains incompletely understood. Current clinical evidence consists primarily of physiological studies, retrospective cohorts, case series, and a limited number of prospective comparative studies. Collectively, these data suggest that HFNC can reduce obstructive respiratory events and improve oxygenation in selected pediatric populations, including children with persistent OSA, CPAP intolerance, medical complexity, and syndromic conditions. Nevertheless, important uncertainties remain regarding optimal patient selection, titration strategies, patient monitoring, long-term adherence and comparative effectiveness relative to CPAP. This review summarizes the physiological basis of HFNC therapy, critically appraises the current clinical evidence, discusses practical considerations related to adherence and implementation, and highlights key knowledge gaps and future research priorities. Overall, HFNC should be viewed as an alternative for selected children who cannot tolerate CPAP, rather than as a universal substitute for pressure-based therapy. Full article

High-performance ammonia (NH₃) sensors play a critical role in environmental protection and noninvasive medical diagnosis. This work reports a new NH₃ sensor based on Au-microsphere-decorated polyaniline (PANI) manufactured by a precise in situ inkjet printing method on a MEMS micro-hotplate. The in situ oxidative polymerization of aniline was performed directly on the MEMS platform using AuCl₃ as a bifunctional oxidant and precursor, with a hierarchical morphology of microspheres (~750 nm) and nanorods (~250 nm). Reduced from Au³⁺ in the polymerization reaction, Au microparticles achieve substantial catalytic promotion by virtue of chemical sensitization and spillover effect. The optimized Au–PANI MEMS sensor exhibits a superlative response of 201% toward 1 ppm NH₃ at room temperature, with an ultra-low theoretical limit of detection (LOD) of 0.42 ppb. Furthermore, the device demonstrates rapid response/recovery kinetics (76 s/72 s), exceptional selectivity against common interfering gases (SO₂, CO, H₂, etc.), and robust long-term stability with high response retention over two months. This research provides a scalable, cost-effective strategy for the mass production of miniaturized, high-sensitivity gas sensors for industrial and healthcare applications. Full article

Background/Objectives: Metabolic indices such as HOMA-IR, METS-IR and TyG play a critical role in determining cardiometabolic risk and insulin resistance in clinical practice. This study aims to simultaneously predict these three indices using ensemble learning models, based on demographic, clinical, and laboratory data from patients with gout. Methods: Demographic, retrospective clinical, and laboratory data from 411 patients diagnosed with gout were analyzed, and a logarithmic transformation was applied to address skewness in the target variable. A genetic algorithm was used to identify relevant features for predicting metabolic indices, and four scenarios were designed. Five ensemble learning models were optimized using fine-tuning with Optuna. The models’ decisions were clinically validated using SHAP analysis. Results: Across all scenarios, the CatBoost model combined with the GA + Log-Transformed framework achieved the highest prediction accuracy and the lowest error rates. Notably, when predicting the TyG index, it simulated the underlying formula with near-perfect accuracy. SHAP analysis confirmed that CatBoost successfully mapped clinical pathophysiology by prioritizing insulin levels for HOMA-IR, BMI for METS-IR, and triglyceride variance for the TyG index. Conclusions: The proposed GA + Log-Transformed CatBoost workflow provides a highly accurate, non-invasive and interpretable clinical decision support system. This study demonstrates that the ensemble architecture effectively captures complex pathophysiological patterns aligned with medical knowledge rather than merely memorizing statistical noise. Full article

Reactive oxygen and nitrogen species (RONS) generated by medical gas plasmas are considered major mediators of plasma-induced biological effects. This includes the atmospheric pressure argon plasma jet kINPen routinely used in clinical applications. The jet’s biomedical action has been shown to be tailored by modifying its feed gas. However, a systematic comparison of how feed gas composition and humidity shape plasma chemistry remains lacking, which would shift application-specific plasma chemistries from guessing to designing. In this study, we systematically investigated, compared, and statistically related 65 individual feed gas conditions of the kINPen argon plasma jet by increasing O₂, N₂, and combined O₂ + N₂ admixtures under dry and humidified conditions. Plasma gas phases were assessed using optical emission spectroscopy and reactive species produced in liquid via hydrogen peroxide, nitrite, and nitrate quantification. O₂-containing admixtures generally reduced overall plasma emission and liquid-phase RONS accumulation, whereas N₂-containing admixtures preferentially enhanced nitrogen-associated emission features. Water vapor addition via the admixture gas stream acted as an important secondary tuning parameter, exerting the strongest effects under combined O₂ + N₂ conditions. Multivariate analyses confirmed clear separation of chemistry profiles according to feed gas composition and humidity, while correlation and regression analyses identified several condition-dependent relationships between gas-phase emissions and liquid-phase reaction products. These data provide a comprehensive characterization of kINPen plasma chemistry under controlled feed gas modification and establish a reference framework for tailoring plasma-derived reactive species profiles in future plasma biology and medicine studies. Full article

Considering the various applications where detection is required—whether for industrial or medical purposes—providing cost-efficient, stable, and highly selective solutions remains challenging. Different industries require hydrogen detectors, because this gas has the potential to serve as a clean and versatile energy carrier; therefore, precise monitoring and feedback in such systems are of enormous importance. Simultaneously, the medical field is developing new therapeutic methods using hydrogen as a medical gas, while also utilizing it as a biomarker in exhaled breath for various gastric diseases. In this paper, a ZnO-based gas sensor, doped with Ag nanoparticles produced via the Solution Chemical Synthesis (SCS) method, was coated with a thin polymer film of poly(1,3,5,7-tetravinyl-1,3,5,7-tetramethylcyclotetrasiloxane) PV4D4 via initiated Chemical Vapor Deposition (iCVD). The results are promising: at a relatively high operating temperature of 350 °C, the sensor showed its highest registered response to H₂ gas (up to 23%). Compared to other gases studied at the same temperature, the sensor also showed potential for detecting 2-propanol, n-butanol, and ethanol, albeit with lower responses. Based on the dynamic response analysis, the fastest reaction time was also recorded at the highest operating temperature, thus showing versatile possibilities for using the specified detector. Full article

Objective: Voltage-gated potassium channel genes are among the most frequently implicated in epilepsy and antiseizure medication (ASM) response. In this pilot study, we aimed to identify rare and common variants by sequencing voltage-gated potassium channel (Kv) genes in epilepsy patients using ASM, and to reveal the potential drug responses of these variants. Methods: To investigate the role of genetic variants in Kv genes (KCNQ1, KCNQ2, KCNQ3, KCNA1, KCNA2, and KCNV2) in response to ASMs among 31 epilepsy patients, we used targeted next-generation sequencing (tNGS). Patients were classified as responders or persistent based on seizure control status. Selected variants in the genes were annotated, filtered, and analyzed for association with ASM response. Results: We identified 181 variants in the 6 channel genes, including missense, synonymous, intronic, UTR, and stop-gained variants. Six variants of uncertain significance (VUSs) were observed, including KCNA2c.*1314C>T, KCNQ1c.*976G>A, KCNQ2 (c.2613G>T p.Arg871Ser and c.1148+62T>G), and KCNQ3 (c.*6282A>G and c.*2860T>C). Two novel variants were identified in our study group, KCNA2:c.*1314C>T and KCNQ3:c.*2860T>C. Both were located in the 3′ UTR region and classified as VUSs according to ACMG guidelines. In the KCNV2 gene, the CG haplotype comprising rs7029012 and rs10967705 was observed more frequently in patients with drug-persistent epilepsy than in those with drug-responsive epilepsy (18.5% vs. 0.8%; χ² = 6.756, p = 0.009, BH-FDR q = 0.036), suggesting a potential association with pharmacoresistant epilepsy. Conclusions: Our haplotype analysis suggests the potential pharmacogenetic contribution of the KCNV2 gene to ASM response; however, these exploratory findings require validation in larger independent cohorts and functional studies. Full article

Background/Objectives: Germany’s 2019 Digital Healthcare Act allows manufacturers to integrate digital health applications (DiGAs) into statutory health insurance if they demonstrate a medical benefit or patient-relevant structural or procedural improvement, substantiated by comparative studies. However, existing reviews indicate that the quality of evidence in these studies is inconsistent. Methods: A scoping review following the PRISMA-ScR guidelines was conducted using MEDLINE on 16 December 2024, via PubMed, Scopus, EMBASE, and Cochrane Library. Studies published between 2020 and 2024 assessing DiGA evaluation tools, study quality, and the strength of evidence were included, while non-DiGA studies, telemedicine research, and register-based studies were excluded. Results: Out of the 4628 publications screened, 16 met the inclusion criteria. Across the nine dimensions of evidence quality, deficits were most frequently identified in relation to validity (nine publications), transparency (seven), objectivity (six), consistency (five), and reliability (five), followed by relevance, generalizability, and accuracy (four each) and timeliness (two). Conclusions: The findings highlight substantial limitations in the quality of DiGA studies, including high dropout rates, a lack of blinding, gender imbalance, a high risk of bias, small sample sizes, and biased control-group designs. Additionally, DiGA usage durations were often shorter than recommended. Strengthening the evidence base for DiGAs requires balancing methodological rigor with the practical realities of digital health development. Sustainable integration into routine care depends on feasible evaluation pathways that enable continuous, real-world evidence generation and address the financial and operational challenges of high-quality evaluations. Full article

Digital technologies are central to student life, but evidence is limited on whether digital-use scales can provide useful thresholds for identifying psychological distress among medical students. This single-center cross-sectional study analyzed complete data from 600 undergraduates at a medical university in southern Vietnam. Stress, depression, and anxiety symptoms were classified using the DASS-21, while problematic smartphone use, social media use, and gaming-related problems were assessed using the SABAS, BSMAS, and a six-item GAS adaptation, respectively. Receiver operating characteristic analyses and the Youden index were used to estimate discrimination and candidate cut-offs. Non-normal DASS-21 scores were observed for stress (30.4%), depression (37.8%), and anxiety (39.0%), predominantly within the mild range. For stress, the AUCs and cut-offs were 0.75 (95% CI 0.70–0.80; ≥23.5) for SABAS, 0.67 (0.62–0.71; ≥17.5) for BSMAS, and 0.64 (0.60–0.70; ≥15.5) for GAS. For depression, the corresponding values were 0.62 (0.57–0.66; ≥21.5), 0.68 (0.63–0.73; ≥18.5), and 0.60 (0.55–0.65; ≥14.5). For anxiety, they were 0.60 (0.55–0.64; ≥20.5), 0.62 (0.57–0.67; ≥17.5) and 0.55 (0.51–0.60; ≥15.5). Sensitivity was low across thresholds (35.0–59.0%). These candidate cut-offs showed modest discrimination and should be considered only as preliminary behavioral flags prompting validated mental health assessment, not as stand-alone screening or diagnostic criteria. Full article

Background/Objectives: Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition characterized by a complex and multifactorial genetic architecture. In this study, we report a male patient, born to non-consanguineous healthy parents, presenting with ADHD and oppositional defiant disorder (ODD). Methods: Trio-based whole-exome sequencing (WES) was performed in the proband and both parents. Variant classification was performed according to American College of Medical Genetics and Genomics (ACMG) guidelines, and the potential pathogenicity of the identified variant was further assessed through multiple in silico prediction algorithms and protein structural analyses. Results: WES identified a homozygous variant in the LNX2 gene (NM_153371.4: c.1165G>A, p.Ala389Thr), classified as a variant of uncertain significance (VUS) and supported by multiple in silico predictions. LNX2 is expressed during brain development and encodes an E3 ubiquitin ligase involved in neuronal differentiation and synaptic function. The identified variant is located within the PDZ2 domain, a functionally relevant region involved in protein–protein interactions. Although the variant is reported in population databases (gnomAD ID: rs148429804), it has not been associated with any clinical phenotype, and its presence in the homozygous state has been reported only once, remaining extremely rare and lacking clinical annotation. Structural modelling predicted localized rearrangement of the hydrogen-bonding network within the PDZ2 domain without major conformational changes. Integrative transcriptomic, and single-cell analyses further supported the biological relevance of LNX2 in neurodevelopment, highlighting its preferential association with neuronal projection-cell networks, synaptic vesicle trafficking pathways, and neuron-specific regulatory programs. Conclusion: Although the identified LNX2 variant cannot be considered causative for the patient’s phenotype and a definitive disease–gene relationship cannot be established based on a single individual, the complementary genetic, structural, and transcriptomic findings support the biological plausibility of LNX2 as a candidate gene for neurodevelopmental disorders. Additional independent patients and functional studies will be required to clarify its contribution to human disease. Full article

Background and objectives: Optimal oxygen administration during delivery room resuscitation remains a major challenge in very preterm infants. While both hypoxemia and excessive oxygen exposure have been associated with adverse outcomes, the prognostic value of early oxygenation parameters remains unclear. This study aimed to evaluate the association between preductal SpO₂ at 5 min of life and early respiratory and neurological outcomes in preterm infants born at or below 32 weeks of gestation. Materialsandmethods: This retrospective single-centre study included 31 preterm infants born at ≤32 weeks of gestation, identified from 34 consecutive eligible births. Demographic, delivery room, respiratory, laboratory, and neuroimaging data were collected from medical records. The primary outcome was intraventricular hemorrhage (IVH), graded by the Papile classification, during the first week of life. Secondary outcomes included respiratory support requirements, surfactant administration, and capillary blood gas parameters at two hours of life. Associations were evaluated using Spearman rank correlation; because SpO₂@5 and delivery room FiO₂ were strongly related to gestational age, partial correlations controlling for gestational age were additionally performed, together with a group comparison for IVH. Exact two-sided p values are reported. Results: The median gestational age was 28 weeks + 4 days (range: 22 weeks + 1 day to 31 weeks + 5 days), and the median birth weight was 1120 g. IVH of any grade occurred in 20 infants (64.5%), including severe (grade III–IV) IVH in 10 (32.3%). Median delivery room FiO₂ was 35% (IQR 30–50%), and median SpO₂ at 5 min of life was 83% (IQR 75–90%). Lower SpO₂ at 5 min of life was associated with an increased number of surfactant doses (rs = −0.46, p = 0.010), lower capillary pH at two hours of life (rs = 0.39, p = 0.032), and a higher grade of IVH (rs = −0.39, p = 0.030); median SpO₂@5 was 80% in infants with IVH versus 90% in those without (p = 0.057). Higher delivery room FiO₂ was associated with increased use of DuoPAP (rs = 0.36, p = 0.045), mechanical ventilation (rs = 0.41, p = 0.021), and surfactant administration (rs = 0.56, p < 0.001), as well as lower pH (rs = −0.55, p = 0.002) and higher lactate levels (rs = 0.37, p = 0.044) at two hours of life. Because SpO₂@5 and FiO₂ were both strongly correlated with gestational age (rs = 0.54 and −0.76, respectively), all associations were re-examined controlling for gestational age. The associations of SpO₂@5 with IVH grade (partial rs = −0.22, p = 0.247), surfactant doses (partial rs = −0.08, p = 0.678) and 2 h pH (partial rs = 0.19, p = 0.335) were attenuated and no longer significant, as were those of FiO₂ with mechanical ventilation (partial rs = −0.04, p = 0.817) and surfactant doses (partial rs = −0.01, p = 0.945); only the association between FiO₂ and 2 h pH persisted (partial rs = −0.37, p = 0.048). Conclusions: In preterm infants born at or below 32 weeks of gestation, lower SpO₂ at 5 min and higher delivery room oxygen requirements were associated with less favorable respiratory and metabolic outcomes, as well as with IVH. However, apart from the association between FiO₂ and 2 h pH, none of these associations remained statistically significant after adjustment for gestational age, and these findings, from a small and heterogeneous single-centre cohort, should be considered hypothesis-generating. Early oxygenation parameters are best viewed as simple bedside markers of cardiopulmonary adaptation and overall illness severity in very preterm infants, rather than as independent predictors of clinical outcomes. Further prospective studies are needed to confirm these associations and define clinically relevant threshold values. Full article

The objective of this research is the development of a copper-based optical sensor for the detection of ovarian cancer marker CA 125 synthesized using low-temperature plasma. Optical materials produced with metals show unique advantages due to their ability to interact with light. There are different methods currently used for the synthesis of optical materials that can be associated with longer processing times and low material yield. The novelty of this study is the development of copper-based optical material (CuPy) using low-temperature plasma and subsequent modification for the detection of CA 125. Introduction: Plasma consists of a mixture of fully and partially ionized gas. It comprises diverse, highly energized species of atoms, ions, electrons, excited molecules, and charged species. These energized species are used to create new materials, for surface modifications, and in medical applications. Plasma can create a controlled environment for the creation of novel materials. Using low-temperature plasma, it will be possible to have precise control of the chemical composition and structure due to the creation of excited molecules, ions, and free radicals. Method: The CuPy material was synthesized using radio-frequency-assisted low-temperature plasma. Prior to synthesis, the plasma chamber was cleaned using radio frequency (RF) plasma without any reagents or gases. RF plasma was used for the synthesis of CuPy for 10 min and subsequent hydrogen plasma (50 sccm) for another 10 min. Two types of products were extracted from the chamber (one in water and another in methanol). These two products were analyzed using UV–visible absorbance spectroscopy, fluorescence spectroscopy, X-ray photoelectron spectroscopy (XPS), and Fourier transform infrared spectroscopy (FTIR). The methanol extracted samples were further modified with CA 125 antibody. Zeta potential measurements were performed to confirm the binding of the CA 125 antibody to the sensor. The sensing efficacy of the sensor towards CA 125 antigen was monitored using fluorescence spectroscopy. Results: The absorbance spectrum of methanol extracted CuPy shows absorbances around 251 nm, 282 nm, and 339 nm. The extracted product exhibited a red edge excitation emission in the visible region. The elemental composition and oxidation state of the sample were evaluated using XPS. CA 125 antibody conjugation with CuPy was confirmed using UV–visible absorbance spectroscopy, fluorescence spectroscopy, and FTIR spectroscopy. The antibody binding resulted in the fluorescence shifts towards higher wavelengths with an increase in the emission intensity compared with CuPy. Zeta potential measurements also confirmed the binding of the CA 125 antibody to the sensor. Different concentrations of CA 125 antigen resulted in the quenching of fluorescence. This change in the fluorescence intensity was used for the detection of CA 125. Conclusions: A copper-based optical material was developed using low-temperature plasma, and it was found to be effective for the detection of CA 125 ovarian cancer marker. Full article