Effects of etomidate versus propofol for total intravenous anaesthesia on postoperative quality of recovery in patients undergoing day-case laparoscopic cholecystectomy: protocol for a multicentre, randomised controlled non-inferiority trial.

Background: The choice of anaesthetic agents may influence specific aspects of postoperative recovery, such as haemodynamic stability, recovery times and the incidence of adverse events, in patients undergoing day-case laparoscopic cholecystectomy. Propofol is widely used in total intravenous anaesthesia (TIVA) for its favourable recovery profile, while etomidate, valued for its haemodynamic stability, is less commonly used due to concerns about adrenal suppression. This study aims to compare etomidate-based and propofol-based TIVA on postoperative quality of recovery in patients undergoing day-case laparoscopic cholecystectomy, hypothesising that etomidate is non-inferior to propofol.

Effects of ciprofol on postoperative delirium and outcomes in older patients undergoing major thoracic surgery: protocol for a multicentre, prospective, single-blinded, randomised controlled study.

Introduction: Postoperative delirium (POD) is a notable complication in older adults undergoing major thoracic surgery and is associated with poor clinical outcomes. Ciprofol, an innovative sedative known for its haemodynamic stability, holds the potential to lower the risk of POD. However, high-quality evidence supporting this claim is limited.

Persistent depressive-symptom trajectories predict conversion from mild cognitive impairment to Alzheimer's disease: A longitudinal ADNI study.

Background: Depressive symptoms are increasingly recognized as a modifiable risk factor for Alzheimer's disease (AD). However, most studies have assessed these symptoms at a single time point or within overlapping symptom-outcome windows, limiting temporal inference.

Methods: We analyzed 397 participants with baseline mild cognitive impairment (MCI) from the Alzheimer's Disease Neuroimaging Initiative.

The HM-TARGET personalised real-time haemodynamic targets in critical care.

Haemodynamic management in critical care typically relies on static, population-based targets that overlook patient-specific physiology and the evolving nature of illness. We develop and validate a framework for real-time, personalised haemodynamic management using a time-dependent Cox model that integrates static and dynamic clinical data to predict survival probabilities and derive optimal heart rate and systolic blood pressure targets over time. Trained on the electronic Intensive Care Unit dataset and externally validated with Medical Information Mart for Intensive Care IV and Indiana University Health cohorts, the model demonstrates high predictive accuracy (c-index up to 0.

A Genome-wide study on the genetic and causal effects of smoking in neurodegeneration.

Background: Smoking represents the largest preventable risk factor for human health, yet previous studies have failed to establish conclusive evidence regarding the causal relationship between smoking and neurodegenerative diseases. This study employs genetic correlation and Mendelian randomization analyses to investigate the potential association between smoking and neurodegenerative disorders.

Methods: This study analyzed summary data from genome-wide association studies (GWAS) on smoking and neurodegenerative diseases.

The effectiveness of mindful walking based on the timing it right framework in patients with atrial fibrillation and chronic heart failure.

Objective: To explore the effects of mindful walking (MFW) based on the Timing It Right (TIR) framework on anxiety, depression, and cardiopulmonary function in patients with atrial fibrillation combined with chronic heart failure.

Methods: A total of 86 patients with atrial fibrillation and chronic heart failure admitted to the cardiology department of our hospital between June 2023 and March 2024 were enrolled in this study. Two homogeneous management wards were selected, with 43 patients from Ward A serving as the control group and 43 patients from Ward B as the intervention group.

Neutrophil-derived exosomes promote sepsis-related multiple organ dysfunction through the induction of neutrophil extracellular trap formation.

Our previous studies have demonstrated that neutrophils play a key role in septic organ injury partly through the excessive formation of neutrophil extracellular traps (NETs) and that exosomes participate in the regulation of NET formation during sepsis. Therefore, this study aimed to determine whether neutrophil-derived exosomes promote the formation of NETs and induce multiple organ dysfunction during sepsis. Initially, polymorphonuclear neutrophil (PMN)-derived exosomes following in vitro stimulation with PBS or LPS (1 μg/mL) for 6 h.

Association of Dexmedetomidine With Postoperative Depressive Symptoms in Older Surgical Patients: A Prospective Multicenter Study.

Background: Neuropsychiatric symptoms significantly impact surgical recovery, quality of life, and long-term survival. To investigate the association between intraoperative dexmedetomidine administration and the incidence of postoperative depressive symptoms in noncardiac surgical patients.

Methods: A multicenter prospective observational study of older surgical patients over 65 years of age from April 2020 to April 2022.

ω-3 PUFAs Alleviate GJ-Cx43 Uncoupling Induced by Long-Term Isoflurane Exposure by Activating the Wnt/β-catenin Signaling Pathway in Astrocytes.

Isoflurane, a widely used anesthetic, has raised concerns due to its potential neurotoxic effects, including oxidative stress and astrocytic gap junction (GJ) dysfunction. This study investigates whether ω-3 polyunsaturated fatty acids (PUFAs), particularly docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), can mitigate these effects by activating the Wnt/β-catenin signaling pathway. Using primary astrocytes, we found that long-term isoflurane exposure uncoupled GJ-Cx43, increased reactive oxygen species (ROS), and inhibited Wnt/β-catenin signaling.

Temporal patterns of cognitive decline after hypertension onset among middle-aged and older adults in China.

Individuals with prevalent hypertension are at an increased risk of developing dementia and tend to exhibit lower cognitive function. However, the magnitude of cognitive change following the onset of new hypertension remains uncertain. A cohort of 7949 adults aged 45 and older without hypertension at baseline was followed prospectively for 7 years.

Microglia modulate integrity of myelin and proliferation of oligodendrocyte precursor cells in murine model of bone cancer pain.

Cancer pain, a frequent complication in patients with cancer, adversely affects quality of life and survival rates. Microglia promote nociceptive information transmission by modulating myelin integrity during pain perception. However, the specific mechanisms by which microglia regulate myelin in the context of cancer pain remain poorly understood.

Mitochondria-targeting Bimetallic Cluster Nanozymes Alleviate Neuropathic Pain Through Scavenging ROS and Reducing Inflammation.

Neuropathic pain is a significant public health concern. Inflammatory mediators and reactive oxygen species (ROS) are recognized as primary contributors to pain perception. In this study, a mitochondria-targeted modification of bimetallic cluster nanozyme (TPP-Au-Ru) is developed.

Deciphering the CREB-NR2B axis: Unraveling the crosstalk of insulin and TGF-β signalling in ameliorating postoperative cognitive dysfunction.

Postoperative cognitive dysfunction (POCD) is a significant postoperative complication, particularly in the elderly, linked to inflammation-mediated neural dysfunction. Insulin resistance and disruptions in transforming growth factor beta (TGF-β) signalling are associated with cognitive decline in aging, yet their roles in POCD are not fully understood. Here, we demonstrated that both insulin and TGF-β pathways were disrupted in POCD mouse models, with recombinant insulin and TGF-β treatments improving cognitive outcomes.

Evaluative Methodology for HRD Testing: Development of Standard Tools for Consistency Assessment.

Homologous recombination deficiency (HRD) has emerged as a critical prognostic and predictive biomarker in oncology. However, current testing methods, especially those reliant on targeted panels, are plagued by inconsistent results from the same samples. This highlights the urgent need for standardized benchmarks to evaluate HRD assay performance.

Novel drug targets for delirium based on genetic causality.

Background: Effective treatment and prevention of delirium remain challenging, largely due to the limited efficiency in identifying and validating drug targets. To address this gap, we performed a systematic Mendelian Randomization (MR) study of the druggable genome to identify potential therapeutic targets for delirium.

Methods: To identify therapeutic targets for delirium, we conducted MR and colocalization analyses using cis-eQTL data (31,684 blood samples and 1387 brain samples) and genome-wide association study (GWAS) data for delirium (discovery cohort N = 431,880; validation cohort N = 403,037).

Nsun2 controls cardiac homeostasis and hypertrophic response by regulating PRKACA expression.

Internal modifications of mammalian RNA have been suggested to be essential for the maintenance of cardiac homeostasis. However, the role of RNA cytosine methylation (m5C) in the heart remains largely unknown. Bulk and single cell RNA sequencing data and tissues from the human hearts were exploited for analyzing the expression of RNA m5C modifying proteins.

Clinical biomarkers of perioperative neurocognitive disorder: initiation and recommendation.

Perioperative neurocognitive disorder (PND) is a significant neurological complication in aging perioperative patients that impacts post-operative cognition. PND is currently diagnosed through cognitive function testing, which is limited by its subjectivity and time requirements. Thus, the identification of biomarkers to assess PND onset is a priority to identify at-risk individuals and enable interventions and treatments to patient outcomes.

Risk factors for the delayed discharge from anesthesia intensive care unit: a single-center retrospective study.

Background: A single-center retrospective study was designed to investigate the risk factors associated with delayed discharge from the Anesthesia Intensive Care Unit (AICU).

Methods: This retrospective study involved patients admitted in the AICU from January 2017 to December 2022. Risk factors for the delayed discharge from the AICU were analyzed by the binary multivariate logistic regression analysis.

Association of the Revised Cardiac Risk Index with 1-year postoperative mortality: A single-center retrospective study.

Objective: To explore risk factors for 1-year postoperative mortality and to identify its association with the Revised Cardiac Risk Index (RCRI).

Methods: This was a retrospective cohort study involving 54,933 patients aged 18 years and above who were surgically treated under general or regional anesthesia in a tertiary hospital in Singapore. Independent risk factors for 1-year postoperative mortality were identified by univariate Cox regression analysis.

The role of the CCL5-CCR5 axis in microglial activation leading to postoperative cognitive dysfunction.

Postoperative cognitive dysfunction (POCD) is a common complication following surgeries involving general anesthesia. Although the CCL5-CCR5 axis is implicated in various neurological conditions, its role in POCD remains unclear. In our POCD model, we observed an increase in CCL5 and CCR5 levels concurrent with microglial activation and significant upregulation of inflammatory cytokines IL-6 and IL-1β.

Effects of volatile anaesthetics on incidence of postoperative depression and anxiety symptoms in elderly patients: A retrospective analysis of a prospective cohort study.

Studies have suggested volatile anaesthetics may alleviate depression and anxiety symptoms in patients. However, there is a paucity of research in this area. We wanted to determine the association between volatile anaesthetics and depression/anxiety symptoms in elderly patients within 7 days after surgery.

Multifunctional Analgesic Sutures from Microfluidic Spinning Technology.

Sutures are the most commonly used wound repair method after surgery. However, addressing delayed recovery and pain management remains a significant challenge. Here, microfibers are developed from microfluidic spinning with long-lasting analgesia capabilities for sutures.